Sample records for generic icf core

  1. [Functioning and disability: the International Classification of Functioning, Disability and Health (ICF)].

    PubMed

    Fernández-López, Juan Antonio; Fernández-Fidalgo, María; Geoffrey, Reed; Stucki, Gerold; Cieza, Alarcos

    2009-01-01

    The World Health Organization's International Classification of Functioning, Disability and Health (ICF) has provided a new foundation for our understanding of health, functioning, and disability. It covers most of the health and health-related domains that make up the human experience, and the most environmental factors that influence that experience of functioning and disability. With the exhaustive ICF, patients' functioning -including its components body functions and structures and activities and participation-, becomes a central perspective in medicine. To implement the ICF in medicine and other fields, practical tools (= ICF Core Sets) have been developed. They are selected sets of categories out of the whole classification which serve as minimal standards for the assessment and reporting of functioning and health for clinical studies and clinical encounters (Brief ICF Core Set) or as standards for multiprofessional comprehensive assessment (Comprehensive ICF Core Set). Different from generic and condition-specific health-status measures, the ICF Core Sets include important body functions and structures and contextual factors. The use of the ICF Core Sets provides an important step towards improved communications between healthcare providers and professionals, and will enable patients and their families to understand and communicate with health professionals about their functioning and treatment goals. Specific applications include multi- and interdisciplinary assessment in clinical settings and in legal expert evaluations and use in disease or functioning-management programs. The ICF has also a potential as a conceptual framework to clarify an interrelated universe of health-related concepts which can be elucidated based on the ICF and therefore will be an ideal tool for teaching students in all medical fields and may open doors to multi-professional learning.

  2. Use of the International Classification of Functioning, Disability and Health Generic-30 Set for the characterization of outpatients: Italian Society of Physical and Rehabilitative Medicine Residents Section Project.

    PubMed

    Gimigliano, Francesca; De Sire, Alessandro; Gastaldo, Marco; Maghini, Irene; Paoletta, Marco; Pasquini, Andrea; Boldrini, Paolo; Selb, Melissa; Prodinger, Birgit

    2018-06-11

    The International Classification of Functioning, Disability and Health (ICF) Generic- 30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) developed an Italian modification of the simple and intuitive descriptions (SID) of these categories. This study was the first one to implement the use of the SID in practice. 1) To implement the use of the ICF in clinical practice and research among Italian Residents in PRM. 2) To verify if the SID made the application of ICF Generic 30 Set more user-friendly than the original descriptions. 3) To examine the prevalence of functioning problems of patients accessing Rehabilitation Services to serve as reference for the development of an ICF-based clinical data collection tool. Multicenter cross-sectional study. Italian Physical Medicine and Rehabilitation (PRM) outpatient rehabilitation services. Patients referring to Italian PRM outpatient rehabilitation services and Italian Residents in PRM. Each School of Specialization involved, randomly, received the ICF Generic-30 Set with the original descriptions or with the SID. Residents collected over a 4-month period (April-July 2016) patients data related to the ICF Generic-30 Set categories. Moreover, the residents self- assessed their difficulty in using the ICF Generic-30 Set with the original descriptions or with the SID, through a Numeric Rating Scale (NRS). Ninety-three residents collected functioning data of 864 patients (mean aged 57.7±19.3) with ICF Generic-30 Set: 304 with the original descriptions and 560 with SID. The difficulty in using the ICF Generic-30 Set with SID was rated as lower than using the original descriptions (NRS = 2.8±2.5 vs 3.5±3.1; p<0.001). The most common disease was the back pain (9.6%) and the most common altered ICF categories were b280 (76.3%) and b710 (72.9%). This multicenter cross-sectional study shown that the ICF Generic-30 Set is a valuable instrument for reporting and assessing functioning and disability in clinical populations with different health conditions and along the continuum of care and that SID facilitate the understanding of the ICF categories and therefore their use in clinical practice. This National survey, improving the knowledge of ICF among Italian PRM residents, represents an important step towards the system-wide implementation of ICF in the healthcare system.

  3. International Classification of Functioning, Disability and Health Core Sets for cerebral palsy, autism spectrum disorder, and attention-deficit-hyperactivity disorder.

    PubMed

    Schiariti, Verónica; Mahdi, Soheil; Bölte, Sven

    2018-05-30

    Capturing functional information is crucial in childhood disability. The International Classification of Functioning, Disability and Health (ICF) Core Sets promote assessments of functional abilities and disabilities in clinical practice regarding circumscribed diagnoses. However, the specificity of ICF Core Sets for childhood-onset disabilities has been doubted. This study aimed to identify content commonalities and differences among the ICF Core Sets for cerebral palsy (CP), and the newly developed Core Sets for autism spectrum disorder (ASD) and attention-deficit-hyperactivity disorder (ADHD). The categories within each Core Set were aggregated at the ICF component and chapter levels. Content comparison was conducted using descriptive analyses. The activities and participation component of the ICF was the most covered across all Core Sets. Main differences included representation of ICF components and coverage of ICF chapters within each component. CP included all ICF components, while ADHD and ASD predominantly focused on activities and participation. Environmental factors were highly represented in the ADHD Core Sets (40.5%) compared to the ASD (28%) and CP (27%) Core Sets. International Classification of Functioning, Disability and Health Core Sets for CP, ASD, and ADHD capture both common but also unique functional information, showing the importance of creating condition-specific, ICF-based tools to build functional profiles of individuals with childhood-onset disabilities. The International Classification of Functioning, Disability and Health (ICF) Core Sets for cerebral palsy (CP), autism spectrum disorder (ASD), and attention-deficit-hyperactivity disorder (ADHD) include unique functional information. The ICF-based tools for CP, ASD, and ADHD differ in terms of representation and coverage of ICF components and ICF chapters. Representation of environmental factors uniquely influences functioning and disability across ICF Core Sets for CP, ASD and ADHD. © 2018 Mac Keith Press.

  4. How to apply the ICF and ICF core sets for low back pain.

    PubMed

    Stier-Jarmer, Marita; Cieza, Alarcos; Borchers, Michael; Stucki, Gerold

    2009-01-01

    To introduce the International Classification of Functioning, Disability and Health (ICF) as conceptual model and classification and the ICF Core Sets as a way to specify functioning for a specific health condition such as Low Back Pain, and to illustrate the application of the ICF and ICF Core Sets in the context of clinical practice, the planning and reporting of studies and the comparison of health status measures. A decision-making and consensus process was performed to develop the ICF Core Sets for Low Back Pain, the linking procedure was applied as basis for the content comparison of health-status measures and the Rehab-Cycle was used to exemplify the application of the ICE and ICF Core Sets in clinical practice. Two different ICF Core Sets, namely, a comprehensive and a brief, are presented, three different health-status measures were linked to the ICF and compared and a case example of a patient with Low back Pain was described based on the Rehab-Cycle. The ICF is a promising new framework and classification to assess the impact of Low Back Pain. The ICF and practical tools, such as the ICF Core Sets for Low Back Pain, are useful for clinical practice, outcome and rehabilitation research, education, health statistics, and regulation.

  5. Classification of functioning and impairment: the development of ICF core sets for autism spectrum disorder.

    PubMed

    Bölte, Sven; de Schipper, Elles; Robison, John E; Wong, Virginia C N; Selb, Melissa; Singhal, Nidhi; de Vries, Petrus J; Zwaigenbaum, Lonnie

    2014-02-01

    Given the variability seen in Autism Spectrum Disorder (ASD), accurate quantification of functioning is vital to studying outcome and quality of life in affected individuals. The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive, universally accepted framework for the description of health-related functioning. ICF Core Sets are shortlists of ICF categories that are selected to capture those aspects of functioning that are most relevant when describing a person with a specific condition. In this paper, the authors preview the process for developing ICF Core Sets for ASD, a collaboration with the World Health Organization and the ICF Research Branch. The ICF Children and Youth version (ICF-CY) was derived from the ICF and designed to capture the specific situation of the developing child. As ASD affects individuals throughout the life span, and the ICF-CY includes all ICF categories, the ICF-CY will be used in this project ("ICF(-CY)" from now on). The ICF(-CY) categories to be included in the ICF Core Sets for ASD will be determined at an ICF Core Set Consensus Conference, where evidence from four preparatory studies (a systematic review, an expert survey, a patient and caregiver qualitative study, and a clinical cross-sectional study) will be integrated. Comprehensive and Brief ICF Core Sets for ASD will be developed with the goal of providing useful standards for research and clinical practice and generating a common language for functioning and impairment in ASD in different areas of life and across the life span. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.

  6. Towards the system-wide implementation of the International Classification of Functioning, Disability and Health in routine practice: Lessons from a pilot study in China.

    PubMed

    Li, Jianan; Prodinger, Birgit; Reinhardt, Jan D; Stucki, Gerold

    2016-06-13

    In 2011 the Chinese leadership in rehabilitation, in collaboration with the International Classification of Functioning, Disability and Health (ICF) Research Branch, embarked on an effort towards the system-wide implementation of the ICF in the healthcare system in China. We report here on the lessons learned from the pilot phase of testing the ICF Generic Set, a parsimonious set of 7 ICF categories, which have been shown to best describe functioning across the general population and people with various health conditions, for use in routine clinical practice in China. The paper discusses whether classification and measurement are compatible, what number of ICF categories should be included in data collection in routine practice, and the usefulness of a functioning profile and functioning score in clinical practice and health research planning. In addition, the paper reflects on the use of ICF qualifiers in a rating scale and the particularities of certain ICF categories contained in the ICF Generic Set when used as items in the context of Chinese rehabilitation and healthcare. Finally, the steps required to enhance the utility of system-wide implementation of the ICF in rehabilitation and healthcare services are set out.

  7. [The International Classification of Functioning, Disability and Health (ICF) : The implementation of the ICF Core Sets for Hand Conditions in clinical routine as an example of application].

    PubMed

    Coenen, Michaela; Rudolf, Klaus-Dieter; Kus, Sandra; Dereskewitz, Caroline

    2018-05-24

    The International Classification of Functioning, Disability and Health (ICF) provides a standardized language of almost 1500 ICF categories for coding information about functioning and contextual factors. Short lists (ICF Core Sets) are helpful tools to support the implementation of the ICF in clinical routine. In this paper we report on the implementation of ICF Core Sets in clinical routine using the "ICF Core Sets for Hand Conditions" and the "Lighthouse Project Hand" as an example. Based on the ICF categories of the "Brief ICF Core Set for Hand Conditions", the ICF-based assessment tool (ICF Hand A ) was developed aiming to guide the assessment and treatment of patients with injuries and diseases located at the hand. The ICF Hand A facilitates the standardized assessment of functioning - taking into consideration of a holistic view of the patients - along the continuum of care ranging from acute care to rehabilitation and return to work. Reference points for the assessment of the ICF Hand A are determined in treatment guidelines for selected injuries and diseases of the hand along with recommendations for acute treatment and care, procedures and interventions of subsequent treatment and rehabilitation. The assessment of the ICF Hand A according to the defined reference points can be done using electronic clinical assessment tools and allows for an automatic generation of a timely medical report of a patient's functioning. In the future, the ICF Hand A can be used to inform the coding of functioning in ICD-11.

  8. Mapping of a standard documentation template to the ICF core sets for arthritis and low back pain.

    PubMed

    Escorpizo, Reuben; Davis, Kandace; Stumbo, Teri

    2010-12-01

    To identify the contents of a documentation template in The Guide to Physical Therapist Practice using the International Classification of Functioning, Disability, and Health (ICF) Core Sets for rheumatoid arthritis, osteoarthritis, and low back pain (LBP) as reference. Concepts were identified from items of an outpatient documentation template and mapped to the ICF using established linking rules. The ICF categories that were linked were compared with existing arthritis and LBP Core Sets. Based on the ICF, the template had the highest number (29%) of linked categories under Activities and participation while Body structures had the least (17%). ICF categories in the arthritis and LBP Core Sets had a 37-55% match with the ICF categories found in the template. We found 164 concepts that were not classified or not defined and 37 as personal factors. The arthritis and LBP Core Sets were reflected in the contents of the template. ICF categories in the Core Sets were reflected in the template (demonstrating up to 55% match). Potential integration of ICF in documentation templates could be explored and examined in the future to enhance clinical encounters and multidisciplinary communication. Copyright © 2010 John Wiley & Sons, Ltd.

  9. Development of ICF Core Sets to standardize assessment of functioning and impairment in ADHD: the path ahead.

    PubMed

    Bölte, Sven; de Schipper, Elles; Holtmann, Martin; Karande, Sunil; de Vries, Petrus J; Selb, Melissa; Tannock, Rosemary

    2014-12-01

    In the study of health and quality of life in attention deficit/hyperactivity disorder (ADHD), it is of paramount importance to include assessment of functioning. The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive, universally accepted framework for the description of functioning in relation to health conditions. In this paper, the authors outline the process to develop ICF Core Sets for ADHD. ICF Core Sets are subgroups of ICF categories selected to capture the aspects of functioning that are most likely to be affected in specific disorders. The ICF categories that will be included in the ICF Core Sets for ADHD will be determined at an ICF Core Set Consensus Conference, wherein evidence from four preliminary studies (a systematic review, an expert survey, a patient and caregiver qualitative study, and a clinical cross-sectional study) will be integrated. Comprehensive and Brief ICF Core Sets for ADHD will be developed with the goal of providing useful standards for research and clinical practice, and to generate a common language for the description of functioning in ADHD in different areas of life and across the lifespan.

  10. [Can ICF core sets be helpful in preparing a social-medical expert report due to incapacity to work?--a first proposal].

    PubMed

    Kirschneck, M; Legner, R; Armbrust, W; Nowak, D; Cieza, A

    2015-04-01

    Social-medical expert reports from the German statutory pension insurance are essential for the German statutory pension regulatory authority to decide whether to grant services regarding participation as well as retirement pensions due to incapacity to work.The objective of this investigation is to determine whether the ICF Core Sets and other international approaches, such as the EUMASS Core Sets or ICF Core Set for vocational rehabilitation cover the content of the social-medical expert reports as well as to propose an approach how the ICF can be economically used by the social medicine practitioner when writing a social-medical expert report. A retrospective quantitative study design was used to translate a total of 294 social-medical expert reports from patients with low back pain (LBP) or chronic widespread pain (CWP) into the language of the ICF (linking) by 2 independent health professionals and compare the results with the ICF Core Sets for specific health conditions and other international approaches. The content of social-medical expert reports was largely reflected by the condition specific brief ICF Core Sets, brief ICF Core Sets for vocational rehabilitation and EUMASS Core Sets. The weighted Kappa statistic for the agreement between the 2 health professionals who translated the expert reports were in CWP 0.69 with a bootstrapped confidence interval of 0.67-0.71 and in LBP 0.73 (0.71-0.74). The analyses show that the content of social-medical expert reports varies enormously. A combination of a condition specific brief ICF Core Set as well as vocational rehabilitation and EUMASS ICF Core Sets as well as all ICF-categories from the expert reports that were named at least in 50% of it can largely provide a basis for preparing expert reports. Within the scope of implementation the need for a specific ICF Core Set for expert reports of the German statutory pension insurance should be further analyzed and discussed. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Content validation of the international classification of functioning, disability and health core set for stroke from gender perspective using a qualitative approach.

    PubMed

    Glässel, A; Coenen, M; Kollerits, B; Cieza, A

    2014-06-01

    The extended ICF Core Set for stroke is an application of the International Classification of Functioning, Disability and Health (ICF) of the World Health Organisation (WHO) with the purpose to represent the typical spectrum of functioning of persons with stroke. The objective of the study is to add evidence to the content validity of the extended ICF Core Set for stroke from persons after stroke taking into account gender perspective. A qualitative study design was conducted by using individual interviews with women and men after stroke in an in- and outpatient rehabilitation setting. The sampling followed the maximum variation strategy. Sample size was determined by saturation. Concepts from qualitative data analysis were linked to ICF categories and compared to the extended ICF Core Set for stroke. Twelve women and 12 men participated in 24 individual interviews. In total, 143 out of 166 ICF categories included in the extended ICF Core Set for stroke were confirmed (women: N.=13; men: N.=17; both genders: N.=113). Thirty-eight additional categories that are not yet included in the extended ICF Core Set for stroke were raised by women and men. This study confirms that the experience of functioning and disability after stroke shows communalities and differences for women and men. The validity of the extended ICF Core Set for stroke could be mostly confirmed, since it does not only include those areas of functioning and disability relevant to both genders but also those exclusively relevant to either women or men. Further research is needed on ICF categories not yet included in the extended ICF Core Set for stroke.

  12. Validation of the Comprehensive ICF Core Set for Vocational Rehabilitation From the Perspective of Physical Therapists: International Delphi Survey.

    PubMed

    Kaech Moll, Veronika M; Escorpizo, Reuben; Portmann Bergamaschi, Ruth; Finger, Monika E

    2016-08-01

    The Comprehensive ICF Core Set for vocational rehabilitation (VR) is a list of essential categories on functioning based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF), which describes a standard for interdisciplinary assessment, documentation, and communication in VR. The aim of this study was to examine the content validity of the Comprehensive ICF Core Set for VR from the perspective of physical therapists. A 3-round email survey was performed using the Delphi method. A convenience sample of international physical therapists working in VR with work experience of ≥2 years were asked to identify aspects they consider as relevant when evaluating or treating clients in VR. Responses were linked to the ICF categories and compared with the Comprehensive ICF Core Set for VR. Sixty-two physical therapists from all 6 WHO world regions responded with 3,917 statements that were subsequently linked to 338 ICF categories. Fifteen (17%) of the 90 categories in the Comprehensive ICF Core Set for VR were confirmed by the physical therapists in the sample. Twenty-two additional ICF categories were identified that were not included in the Comprehensive ICF Core Set for VR. Vocational rehabilitation in physical therapy is not well defined in every country and might have resulted in the small sample size. Therefore, the results cannot be generalized to all physical therapists practicing in VR. The content validity of the ICF Core Set for VR is insufficient from solely a physical therapist perspective. The results of this study could be used to define a physical therapy-specific set of ICF categories to develop and guide physical therapist clinical practice in VR. © 2016 American Physical Therapy Association.

  13. Content validity of the Comprehensive ICF Core Set for multiple sclerosis from the perspective of speech and language therapists.

    PubMed

    Renom, Marta; Conrad, Andrea; Bascuñana, Helena; Cieza, Alarcos; Galán, Ingrid; Kesselring, Jürg; Coenen, Michaela

    2014-11-01

    The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) is a comprehensive framework to structure the information obtained in multidisciplinary clinical settings according to the biopsychosocial perspective of the International Classification of Functioning, Disability and Health (ICF) and to guide the treatment and rehabilitation process accordingly. It is now undergoing validation from the user perspective for which it has been developed in the first place. To validate the content of the Comprehensive ICF Core Set for MS from the perspective of speech and language therapists (SLTs) involved in the treatment of persons with MS (PwMS). Within a three-round e-mail-based Delphi Study 34 SLTs were asked about PwMS' problems, resources and aspects of the environment treated by SLTs. Responses were linked to ICF categories. Identified ICF categories were compared with those included in the Comprehensive ICF Core Set for MS to examine its content validity. Thirty-four SLTs named 524 problems and resources, as well as aspects of environment. Statements were linked to 129 ICF categories (60 Body-functions categories, two Body-structures categories, 42 Activities-&-participation categories, and 25 Environmental-factors categories). SLTs confirmed 46 categories in the Comprehensive ICF Core Set. Twenty-one ICF categories were identified as not-yet-included categories. This study contributes to the content validity of the Comprehensive ICF Core Set for MS from the perspective of SLTs. Study participants agreed on a few not-yet-included categories that should be further discussed for inclusion in a revised version of the Comprehensive ICF Core Set to strengthen SLTs' perspective in PwMS' neurorehabilitation. © 2014 Royal College of Speech and Language Therapists.

  14. Explanatory power does not equal clinical importance: study of the use of the Brief ICF Core Sets for Spinal Cord Injury with a purely statistical approach.

    PubMed

    Ballert, C; Oberhauser, C; Biering-Sørensen, F; Stucki, G; Cieza, A

    2012-10-01

    Psychometric study analyzing the data of a cross-sectional, multicentric study with 1048 persons with spinal cord injury (SCI). To shed light on how to apply the Brief Core Sets for SCI of the International Classification of Functioning, Disability and Health (ICF) by determining whether the ICF categories contained in the Core Sets capture differences in overall health. Lasso regression was applied using overall health, rated by the patients and health professionals, as dependent variables and the ICF categories of the Comprehensive ICF Core Sets for SCI as independent variables. The ICF categories that best capture differences in overall health refer to areas of life such as self-care, relationships, economic self-sufficiency and community life. Only about 25% of the ICF categories of the Brief ICF Core Sets for the early post-acute and for long-term contexts were selected in the Lasso regression and differentiate, therefore, among levels of overall health. ICF categories such as d570 Looking after one's health, d870 Economic self-sufficiency, d620 Acquisition of goods and services and d910 Community life, which capture changes in overall health in patients with SCI, should be considered in addition to those of the Brief ICF Core Sets in clinical and epidemiological studies in persons with SCI.

  15. Towards system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in routine practice: Developing simple, intuitive descriptions of ICF categories in the ICF Generic and Rehabilitation Set.

    PubMed

    Prodinger, Birgit; Reinhardt, Jan D; Selb, Melissa; Stucki, Gerold; Yan, Tiebin; Zhang, Xia; Li, Jianan

    2016-06-13

    A national, multi-phase, consensus process to develop simple, intuitive descriptions of International Classification of Functioning, Disability and Health (ICF) categories contained in the ICF Generic and Rehabilitation Sets, with the aim of enhancing the utility of the ICF in routine clinical practice, is presented in this study. A multi-stage, national, consensus process was conducted. The consensus process involved 3 expert groups and consisted of a preparatory phase, a consensus conference with consecutive working groups and 3 voting rounds (votes A, B and C), followed by an implementation phase. In the consensus conference, participants first voted on whether they agreed that an initially developed proposal for simple, intuitive descriptions of an ICF category was in fact simple and intuitive. The consensus conference was held in August 2014 in mainland China. Twenty-one people with a background in physical medicine and rehabilitation participated in the consensus process. Four ICF categories achieved consensus in vote A, 16 in vote B, and 8 in vote C. This process can be seen as part of a larger effort towards the system-wide implementation of the ICF in routine clinical and rehabilitation practice to allow for the regular and comprehensive evaluation of health outcomes most relevant for the monitoring of quality of care.

  16. Two steps forward, one step back? A commentary on the disease-specific core sets of the International Classification of Functioning, Disability and Health (ICF).

    PubMed

    McIntyre, Anne; Tempest, Stephanie

    2007-09-30

    The International Classification of Functioning, Disability and Health (ICF) has been received favourably by health care professionals, disability rights organizations and proponents of the social model of disability. The success of the ICF largely depends on its uptake in practice and is considered unwieldy in its full format. To enhance the application of the ICF in practice, disease and site-specific core sets have been developed. The objective of this paper is to stimulate thought and discussion about the place of the ICF core sets in rehabilitation practice. The authors' review of the literature uses the ICF core sets (especially stroke), to debate if the ICF is at risk of taking two steps forward, one step back in its holistic portrayal of health. ICF disease specific core sets could be seen as taking two steps forward to enhance the user friendliness of the ICF and evidence-based practice in rehabilitation. However, there is a danger of taking one step back in reverting to a disease-specific classification. It is too early to conclude the efficacy of the disease-specific core sets, but there is an opportunity to debate where the next steps may lead.

  17. Development of the International Classification of Functioning, Disability and Health core sets for hand conditions--results of the World Health Organization International Consensus process.

    PubMed

    Rudolf, Klaus-Dieter; Kus, Sandra; Chung, Kevin C; Johnston, Marie; LeBlanc, Monique; Cieza, Alarcos

    2012-01-01

    A formal decision-making and consensus process was applied to develop the first version of the International Classification on Functioning, Disability and Health (ICF) Core Sets for Hand Conditions. To convene an international panel to develop the ICF Core Sets for Hand Conditions (HC), preparatory studies were conducted, which included an expert survey, a systematic literature review, a qualitative study and an empirical data collection process involving persons with hand conditions. A consensus conference was convened in Switzerland in May 2009 that was attended by 23 healthcare professionals, who treat hand conditions, representing 22 countries. The preparatory studies identified a set of 743 ICF categories at the second, third or fourth hierarchical level. Altogether, 117 chapter-, second-, or third-level categories were included in the comprehensive ICF Core Set for HC. The brief ICF Core Set for HC included a total of 23 chapter- and second-level categories. A formal consensus process integrating evidence and expert opinion based on the ICF led to the formal adoption of the ICF Core Sets for Hand Conditions. The next phase of this ICF project is to conduct a formal validation process to establish its applicability in clinical settings.

  18. Validation of the Comprehensive ICF Core Set for obstructive pulmonary diseases from the patient's perspective.

    PubMed

    Marques, Alda; Jácome, Cristina; Gonçalves, Ana; Silva, Sara; Lucas, Carla; Cruz, Joana; Gabriel, Raquel

    2014-06-01

    This study aimed to validate the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for obstructive pulmonary diseases (OPDs) from the perspective of patients with chronic obstructive pulmonary disease. A cross-sectional qualitative study was carried out with outpatients with chronic obstructive pulmonary disease using focus groups with an ICF-based approach. Qualitative data were analysed using the meaning condensation procedure by two researchers with expertise in the ICF. Thirty-two participants (37.5% women; 63.8 ± 11.3 years old) were included in six focus groups. A total of 61 (86%) ICF categories of the Comprehensive ICF Core Set for OPD were confirmed. Thirty-nine additional second-level categories not included in the Core Set were identified: 15 from the body functions component, four from the body structures, nine from the activities and participation and 11 from the environmental factors. The majority of the categories included in the Comprehensive ICF Core Set for OPD were confirmed from the patients' perspective. However, additional categories, not included in the Core Set, were also reported. The categories included in the Core Set were not confirmed and the additional categories need to be investigated further to develop an instrument tailored to patients' needs. This will promote patient-centred assessments and rehabilitation interventions.

  19. ICF Core Set for Head and Neck Cancer: Do the Categories Discriminate Among Clinically Relevant Subgroups of Patients?

    ERIC Educational Resources Information Center

    Tschiesner, Uta; Oberhauser, Cornelia; Cieza, Alarcos

    2011-01-01

    The multidisciplinary assessment of functioning in patients with head and neck cancer (HNC) according to the "ICF Core Set for Head and Neck Cancer" (ICF-HNC) was developed in an international and multi-disciplinary approach. The ICF-HNC is an application of the ICF that was adopted by the World Health Organization. The objective of this study was…

  20. Development of the International Classification of Functioning, Disability and Health core sets for bipolar disorders: results of an international consensus process.

    PubMed

    Ayuso-Mateos, José L; Avila, Carolina C; Anaya, Celia; Cieza, Alarcos; Vieta, Eduard

    2013-01-01

    The International Classification of Functioning, Disability and Health (ICF) is a tool of the World Health Organization (WHO) designed to be a guide to identify and classify relevant domains of human experience affected by health conditions. The purpose of this article is to describe the process for the development of two Core Sets for bipolar disorder (BD) in the framework of the ICF. The Comprehensive ICF Core Set for BD intends to be a guide for multidisciplinary assessment of patients diagnosed with this condition, while the Brief ICF Core Set for BD will be useful when rating aspects of patient's experience for clinical practice or epidemiological studies. An international consensus conference involving a sample of experts with different professional backgrounds was performed using the nominal group technique. Various preparatory studies identified a set of 743 potential ICF categories to be included in the Core Sets. A total of 38 ICF categories were selected to be included in the Comprehensive Core Set for BD. A total of 19 ICF categories from the Comprehensive Core Set were chosen as the most significant to constitute the Brief Core Set for BD. The formal consensus process integrating evidence and expert opinion on the ICF led to the formal adoption of the ICF Core Sets for BD. The most important categories included are representative of the characteristics usually associated with BD. The next phase of this ICF project is to conduct a formal validation process to establish its applicability in clinical settings. Implications for Rehabilitation Bipolar disorder (BD) is a prevalent condition that has a great impact on people who suffer it, not only in health but also in daily functioning and quality of life. No standard has been defined so far regarding the problems in functioning of persons with BDs. The process described in this article defines the set of areas of functioning to be addressed in clinical assessments of persons with BD and establish the starting point for the development of condition-specific outcome measures.

  1. Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

    PubMed Central

    Mueller, Martin; Boldt, Christine; Grill, Eva; Strobl, Ralf; Stucki, Gerold

    2008-01-01

    Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets). Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute hospital and early post-acute rehabilitation facilities are highly relevant for rehabilitation nursing. Linking nursing interventions with ICF Core Set categories is a feasible way to analyse nursing. Using the ICF Core Sets to describe goals of nursing interventions both facilitates inter-professional communication and respects patient's needs. The ICF may thus be a useful framework to set nursing intervention goals. PMID:18282288

  2. The International Classification of Functioning (ICF) core set for breast cancer from the perspective of women with the condition.

    PubMed

    Cooney, Marese; Galvin, Rose; Connolly, Elizabeth; Stokes, Emma

    2013-05-01

    The ICF Core Set for breast cancer was generated by international experts for women who have had surgery and radiation but it has not yet been validated. The objective of the study was to validate the ICF Core Set from the perspective of women with breast cancer. A qualitative focus group methodology was used. The sessions were transcribed verbatim. Meaning units were identified by two independent researchers. The agreed list was subsequently linked to ICF categories by two independent researchers according to pre-defined linking rules. Data saturation determined the number of focus groups conducted. Quality of the data analyses was assured by multiple coding and peer review. Thirty-four women participated in seven focus groups. A total of 1621 meaning units were identified which were linked to 74 of the existing 80 Core Set categories. Additional ICF categories not currently included in the Core Set were identified by the women. The validity of the Core Set was largely supported. However, some categories currently not covered by the ICF Core Set for Breast Cancer will need to be considered for inclusion if the Core Set is to reflect all women who have had treatment for breast cancer

  3. A comparison of participation outcome measures and the International Classification of Functioning, Disability and Health Core Sets for traumatic brain injury.

    PubMed

    Chung, Pearl; Yun, Sarah Jin; Khan, Fary

    2014-02-01

    To compare the contents of participation outcome measures in traumatic brain injury with the International Classification of Functioning, Disability and Health (ICF) Core Sets for traumatic brain injury. A systematic search with an independent review process selected relevant articles to identify outcome measures in participation in traumatic brain injury. Instruments used in two or more studies were linked to the ICF categories, which identified categories in participation for comparison with the ICF Core Sets for traumatic brain injury. Selected articles (n = 101) identified participation instruments used in two or more studies (n = 9): Community Integration Questionnaire, Craig Handicap Assessment and Reporting Technique, Mayo-Portland Adaptability Inventory-4 Participation Index, Sydney Psychosocial Reintegration Scale Version-2, Participation Assessment with Recombined Tool-Objective, Community Integration Measure, Participation Objective Participation Subjective, Community Integration Questionnaire-2, and Quality of Community Integration Questionnaire. Each instrument was linked to 4-35 unique second-level ICF categories, of which 39-100% related to participation. Instruments addressed 86-100% and 50-100% of the participation categories in the Comprehensive and Brief ICF Core Sets for traumatic brain injury, respectively. Participation measures in traumatic brain injury were compared with the ICF Core Sets for traumatic brain injury. The ICF Core Sets for traumatic brain injury could contribute to the development and selection of participation measures.

  4. Standardised assessment of functioning in ADHD: consensus on the ICF Core Sets for ADHD.

    PubMed

    Bölte, Sven; Mahdi, Soheil; Coghill, David; Gau, Susan Shur-Fen; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Levy, Florence; Rohde, Luis A; Segerer, Wolfgang; de Vries, Petrus J; Selb, Melissa

    2018-02-12

    Attention-deficit/hyperactivity disorder (ADHD) is associated with significant impairments in social, educational, and occupational functioning, as well as specific strengths. Currently, there is no internationally accepted standard to assess the functioning of individuals with ADHD. WHO's International Classification of Functioning, Disability and Health-child and youth version (ICF) can serve as a conceptual basis for such a standard. The objective of this study is to develop a comprehensive, a common brief, and three age-appropriate brief ICF Core Sets for ADHD. Using a standardised methodology, four international preparatory studies generated 132 second-level ICF candidate categories that served as the basis for developing ADHD Core Sets. Using these categories and following an iterative consensus process, 20 ADHD experts from nine professional disciplines and representing all six WHO regions selected the most relevant categories to constitute the ADHD Core Sets. The consensus process resulted in 72 second-level ICF categories forming the comprehensive ICF Core Set-these represented 8 body functions, 35 activities and participation, and 29 environmental categories. A Common Brief Core Set that included 38 categories was also defined. Age-specific brief Core Sets included a 47 category preschool version for 0-5 years old, a 55 category school-age version for 6-16 years old, and a 52 category version for older adolescents and adults 17 years old and above. The ICF Core Sets for ADHD mark a milestone toward an internationally standardised functional assessment of ADHD across the lifespan, and across educational, administrative, clinical, and research settings.

  5. Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy.

    PubMed

    Prodinger, Birgit; Cieza, Alarcos; Oberhauser, Cornelia; Bickenbach, Jerome; Üstün, Tevfik Bedirhan; Chatterji, Somnath; Stucki, Gerold

    2016-06-01

    To develop a comprehensive set of the International Classification of Functioning, Disability and Health (ICF) categories as a minimal standard for reporting and assessing functioning and disability in clinical populations along the continuum of care. The specific aims were to specify the domains of functioning recommended for an ICF Rehabilitation Set and to identify a minimal set of environmental factors (EFs) to be used alongside the ICF Rehabilitation Set when describing disability across individuals and populations with various health conditions. Secondary analysis of existing data sets using regression methods (Random Forests and Group Lasso regression) and expert consultations. Along the continuum of care, including acute, early postacute, and long-term and community rehabilitation settings. Persons (N=9863) with various health conditions participated in primary studies. The number of respondents for whom the dependent variable data were available and used in this analysis was 9264. Not applicable. For regression analyses, self-reported general health was used as a dependent variable. The ICF categories from the functioning component and the EF component were used as independent variables for the development of the ICF Rehabilitation Set and the minimal set of EFs, respectively. Thirty ICF categories to be complemented with 12 EFs were identified as relevant to the identified ICF sets. The ICF Rehabilitation Set constitutes of 9 ICF categories from the component body functions and 21 from the component activities and participation. The minimal set of EFs contains 12 categories spanning all chapters of the EF component of the ICF. The identified sets proposed serve as minimal generic sets of aspects of functioning in clinical populations for reporting data within and across heath conditions, time, clinical settings including rehabilitation, and countries. These sets present a reference framework for harmonizing existing information on disability across general and clinical populations. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Feasibility of using the International Classification of Functioning, Disability and Health Core Set for evaluation of fall-related risk factors in acute rehabilitation settings.

    PubMed

    Huang, Shih W; Lin, Li F; Chou, Lin C; Wu, Mei J; Liao, Chun D; Liou, Tsan H

    2016-04-01

    Previously, we reported the use of an International Classification of Functioning (ICF) core set that can provide a holistic framework for evaluating the risk factors of falls; however, data on the feasibility of applying this core set are lacking. To investigate the feasibility of applying the fall-related ICF risk-factor core set in the case of patients in an acute-rehabilitation setting. A cross-sectional and descriptive correlational design. Acute-rehabilitation ward. A total of 273 patients who experienced fall at acute-rehabilitation ward. The data on falls were collected from the hospital's Nursing Information System (NIS) and the fall-reporting system (Adverse Event Reporting System, AERS) between 2010 and 2013. The relationship of both systems to the fall-related ICF core set was analyzed to assess the feasibility of their clinical application. We evaluated the feasibility of using the fall-related ICF risk-factor core set by using the frequency and the percentage of the fall patients in of the listed categories. The fall-related ICF risk-factor core set category b735 (muscle tone functions) exhibited a high feasibility (85.95%) for clinical application, and the category b730 (muscle power functions) covered 77.11% of the patients. The feasibility of application of the category d410 (change basic body position) was also high in the case of all fall patients (81.69%). In the acute-rehabilitation setting, the feasibility of application of the fall-related ICF risk-factor core set is high. The fall-related ICF risk-factor core set can help multidisciplinary teams develop fall-prevention strategies in acute rehabilitation wards.

  7. Developing comprehensive and Brief ICF core sets for morbid obesity for disability assessment in Taiwan: a preliminary study.

    PubMed

    Lin, Y-N; Chang, K-H; Lin, C-Y; Hsu, M-I; Chen, H-C; Chen, H-H; Liou, T-H

    2014-04-01

    The International Classification of Functioning, Disability, and Health (ICF) provides a framework for measuring functioning and disability based on a biopsychosocial model. The aim of this study was to develop comprehensive and brief ICF core sets for morbid obesity for disability assessment in Taiwan. Observational Other Twenty-nine multidisciplinary experts of ICF METHODS: The questionnaire contained 112 obesity-relevant and second-level ICF categories. Using a 5-point Likert scale, the participants rated the significance of the effects of each category on the heath status of people with obesity. Correlation between an individual's score and the average score of the group indicated consensus. The categories were selected for the comprehensive core set for obesity if more than 50% of the experts rated them as "important" in the third round of the Delphi exercise, and for the brief core set if more than 80% of the experts rated them "very important." Twenty-nine experts participated in the study. These included 18 physicians, 4 dieticians, 3 physical therapists, 2 nurses, and 2 ICF experts. The comprehensive core set for morbid obesity contained 61 categories. Of these, 26 categories were from the component body function, 8 were from body structure, 18 were from activities and participation, and 9 were from environmental factors. The brief core set for obesity disability contained 29 categories. Of these, 19 categories were from the component body function, 3 were from body structure, 6 were from activities and participation, and one was from environmental factors. The comprehensive and brief ICF core sets provide comprehensive information on the health effects of morbid obesity and concise information for clinical practice. Comprehensive and brief core sets were created after three rounds of Delphi technique. Further validation study of these core sets by applying to patients with morbid obesity is needed. The comprehensive ICF core set for morbid obesity provides comprehensive information on the health effects of morbid obesity; the brief core set can provide concise information for clinical practice.

  8. Patients' functioning as predictor of nursing workload in acute hospital units providing rehabilitation care: a multi-centre cohort study

    PubMed Central

    2010-01-01

    Background Management decisions regarding quality and quantity of nurse staffing have important consequences for hospital budgets. Furthermore, these management decisions must address the nursing care requirements of the particular patients within an organizational unit. In order to determine optimal nurse staffing needs, the extent of nursing workload must first be known. Nursing workload is largely a function of the composite of the patients' individual health status, particularly with respect to functioning status, individual need for nursing care, and severity of symptoms. The International Classification of Functioning, Disability and Health (ICF) and the derived subsets, the so-called ICF Core Sets, are a standardized approach to describe patients' functioning status. The objectives of this study were to (1) examine the association between patients' functioning, as encoded by categories of the Acute ICF Core Sets, and nursing workload in patients in the acute care situation, (2) compare the variance in nursing workload explained by the ICF Core Set categories and with the Barthel Index, and (3) validate the Acute ICF Core Sets by their ability to predict nursing workload. Methods Patients' functioning at admission was assessed using the respective Acute ICF Core Set and the Barthel Index, whereas nursing workload data was collected using an established instrument. Associations between dependent and independent variables were modelled using linear regression. Variable selection was carried out using penalized regression. Results In patients with neurological and cardiopulmonary conditions, selected ICF categories and the Barthel Index Score explained the same variance in nursing workload (44% in neurological conditions, 35% in cardiopulmonary conditions), whereas ICF was slightly superior to Barthel Index Score for musculoskeletal conditions (20% versus 16%). Conclusions A substantial fraction of the variance in nursing workload in patients with rehabilitation needs in the acute hospital could be predicted by selected categories of the Acute ICF Core Sets, or by the Barthel Index score. Incorporating ICF Core Set-based data in nursing management decisions, particularly staffing decisions, may be beneficial. PMID:21034438

  9. A case study on the application of International Classification of Functioning, Disability and Health (ICF)-based tools for vocational rehabilitation in spinal cord injury.

    PubMed

    Glässel, Andrea; Rauch, Alexandra; Selb, Melissa; Emmenegger, Karl; Lückenkemper, Miriam; Escorpizo, Reuben

    2012-01-01

    Vocational rehabilitation (VR) plays a key role in bringing persons with acquired disabilities back to work, while encouraging employment participation. The purpose of this case study is to illustrate the systematic application of International Classification of Functioning, Disability, and Health (ICF)-based documentation tools by using ICF Core Sets in VR shown with a case example of a client with traumatic spinal cord injury (SCI). The client was a 26-year-old male with paraplegia (7th thoracic level), working in the past as a mover. This case study describes the integration of the ICF Core Sets for VR into an interdisciplinary rehabilitation program by using ICF-based documentation tools. Improvements in the client's impairments, activity limitations, and participation restrictions were observed following rehabilitation. Goals in different areas of functioning were achieved. The use of the ICF Core Sets in VR allows a comprehensive assessment of the client's level of functioning and intervention planning. Specifically, the Brief ICF Core Set in VR can provide domains for intervention relevant to each member of an interdisciplinary team and hence, can facilitate the VR management process in a SCI center in Switzerland.

  10. Low back pain in 17 countries, a Rasch analysis of the ICF core set for low back pain.

    PubMed

    Røe, Cecilie; Bautz-Holter, Erik; Cieza, Alarcos

    2013-03-01

    Previous studies indicate that a worldwide measurement tool may be developed based on the International Classification of Functioning Disability and Health (ICF) Core Sets for chronic conditions. The aim of the present study was to explore the possibility of constructing a cross-cultural measurement of functioning for patients with low back pain (LBP) on the basis of the Comprehensive ICF Core Set for LBP and to evaluate the properties of the ICF Core Set. The Comprehensive ICF Core Set for LBP was scored by health professionals for 972 patients with LBP from 17 countries. Qualifier levels of the categories, invariance across age, sex and countries, construct validity and the ordering of the categories in the components of body function, body structure, activities and participation were explored by Rasch analysis. The item-trait χ2-statistics showed that the 53 categories in the ICF Core Set for LBP did not fit the Rasch model (P<0.001). The main challenge was the invariance in the responses according to country. Analysis of the four countries with the largest sample sizes indicated that the data from Germany fit the Rasch model, and the data from Norway, Serbia and Kuwait in terms of the components of body functions and activities and participation also fit the model. The component of body functions and activity and participation had a negative mean location, -2.19 (SD 1.19) and -2.98 (SD 1.07), respectively. The negative location indicates that the ICF Core Set reflects patients with a lower level of function than the present patient sample. The present results indicate that it may be possible to construct a clinical measure of function on the basis of the Comprehensive ICF Core Set for LBP by calculating country-specific scores before pooling the data.

  11. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

    PubMed

    Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

    2015-01-01

    The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most prevalent problems in community-living older adults.

  12. Investigating the International Classification of Functioning, Disability, and Health (ICF) Framework to Capture User Needs in the Concept Stage of Rehabilitation Technology Development.

    PubMed

    Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andy; Levesley, Martin; Bhakta, Bipin

    2014-01-01

    This study evaluates whether the International Classification of Functioning, Disability, and Health (ICF) framework provides a useful basis to ensure that key user needs are identified in the development of a home-based arm rehabilitation system for stroke patients. Using a qualitative approach, nine people with residual arm weakness after stroke and six healthcare professionals with expertise in stroke rehabilitation were enrolled in the user-centered design process. They were asked, through semi-structured interviews, to define the needs and specification for a potential home-based rehabilitation device to facilitate self-managed arm exercise. The topic list for the interviews was derived by brainstorming ideas within the clinical and engineering multidisciplinary research team based on previous experience and existing literature in user-centered design. Meaningful concepts were extracted from questions and responses of these interviews. These concepts obtained were matched to the categories within the ICF comprehensive core set for stroke using ICF linking rules. Most of the concepts extracted from the interviews matched to the existing ICF Core Set categories. Person factors like gender, age, interest, compliance, motivation, choice, and convenience that might determine device usability are yet to be categorized within the ICF comprehensive core set. The results suggest that the categories of the comprehensive ICF Core Set for stroke provide a useful basis for structuring interviews to identify most users needs. However some personal factors (related to end users and healthcare professionals) need to be considered in addition to the ICF categories.

  13. International Classification of Functioning, Disability and Health core set for physical health of older adults.

    PubMed

    Ruaro, João A; Ruaro, Marinêz B; Guerra, Ricardo O

    2014-01-01

    To facilitate a systematic, comprehensive description of functioning and to enable the use of the International Classification of Functioning, Disability and Health (ICF) in clinical practice and research, core sets have been developed. The aim of this study was to propose a version of the ICF core set to classify the physical health of older adults. The proposition of the ICF core set was based on the Delphi technique. The panel of experts included 8 Brazilian researchers (physical therapists, medical doctors, nurses, and physical educators). The communication was wholly electronic. In total, there were 5 rounds of interactivity between the participants to arrive at the final version of the construct. The ICF core set presented 30 categories (14 on body functions, 4 on body structures, 9 on activities or participation, and 3 on environmental factors) and had a Cronbach α of 0.964. The presented core set is a secure, fast, and accurate instrument for assessing the physical health and engagement of older adults. It defines points related to functioning and health that are relevant when evaluating this population, as well as when reevaluating it and monitoring changes.

  14. Content Validity of the Comprehensive ICF Core Set for Multiple Sclerosis from the Perspective of Speech and Language Therapists

    ERIC Educational Resources Information Center

    Renom, Marta; Conrad, Andrea; Bascuñana, Helena; Cieza, Alarcos; Galán, Ingrid; Kesselring, Jürg; Coenen, Michaela

    2014-01-01

    Background: The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) is a comprehensive framework to structure the information obtained in multidisciplinary clinical settings according to the biopsychosocial perspective of the International Classification of Functioning,…

  15. Can the ICF osteoarthritis core set represent a future clinical tool in measuring functioning in persons with osteoarthritis undergoing hip and knee joint replacement?

    PubMed

    Alviar, Maria Jenelyn; Olver, John; Pallant, Julie F; Brand, Caroline; de Steiger, Richard; Pirpiris, Marinis; Bucknill, Andrew; Khan, Fary

    2012-11-01

    To determine the dimensionality, reliability, model fit, adequacy of the qualifier levels, response patterns across different factors, and targeting of the International Classification of Functioning, Disability and Health (ICF) osteoarthritis core set categories in people with osteoarthritis undergoing hip and knee arthroplasty. The osteoarthritis core set was rated in 316 persons with osteoarthritis who were either in the pre-operative or within one year post-operative stage. Rasch analyses were performed using the RUMM 2030 program. Twelve of the 13 body functions categories and 13 of the 19 activity and participation categories had good model fit. The qualifiers displayed disordered thresholds necessitating rescoring. There was uneven spread of ICF categories across the full range of the patients' scores indicating off--targeting. Subtest analysis of the reduced ICF categories of body functions and activity and participation showed that the two components could be integrated to form one measure. The results suggest that it is possible to measure functioning using a unidimensional construct based on ICF osteoarthritis core set categories of body functions and activity and participation in this population. However, omission of some categories and reduction in qualifier levels are necessary. Further studies are needed to determine whether better targeting is achieved, particularly during the pre-operative and during the sub-acute care period.

  16. Conceptual Underpinnings of the Quality of Life in Neurological Disorders (Neuro-QoL): Comparisons of Core Sets for Stroke, Multiple Sclerosis, Spinal Cord Injury, and Traumatic Brain Injury.

    PubMed

    Wong, Alex W K; Lau, Stephen C L; Fong, Mandy W M; Cella, David; Lai, Jin-Shei; Heinemann, Allen W

    2018-04-03

    To determine the extent to which the content of the Quality of Life in Neurological Disorders (Neuro-QoL) covers the International Classification of Functioning, Disability and Health (ICF) Core Sets for multiple sclerosis (MS), stroke, spinal cord injury (SCI), and traumatic brain injury (TBI) using summary linkage indicators. Content analysis by linking content of the Neuro-QoL to corresponding ICF codes of each Core Set for MS, stroke, SCI, and TBI. Three academic centers. None. None. Four summary linkage indicators proposed by MacDermid et al were estimated to compare the content coverage between Neuro-QoL and the ICF codes of Core Sets for MS, stroke, MS, and TBI. Neuro-QoL represented 20% to 30% Core Set codes for different conditions in which more codes in Core Sets for MS (29%), stroke (28%), and TBI (28%) were covered than those for SCI in the long-term (20%) and early postacute (19%) contexts. Neuro-QoL represented nearly half of the unique Activity and Participation codes (43%-49%) and less than one third of the unique Body Function codes (12%-32%). It represented fewer Environmental Factors codes (2%-6%) and no Body Structures codes. Absolute linkage indicators found that at least 60% of Neuro-QoL items were linked to Core Set codes (63%-95%), but many items covered the same codes as revealed by unique linkage indicators (7%-13%), suggesting high concept redundancy among items. The Neuro-QoL links more closely to ICF Core Sets for stroke, MS, and TBI than to those for SCI, and primarily covers activity and participation ICF domains. Other instruments are needed to address concepts not measured by the Neuro-QoL when a comprehensive health assessment is needed. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. [Use of ICF Core Sets for medical reports concerning patients with low back pain and chronic widespread pain syndrome].

    PubMed

    Kirschneck, M; Winkelmann, A; Kirchberger, I; Glässel, A; Ewert, T; Stucki, G; Cieza, A

    2008-11-01

    Medical reports of the national pension insurance are essential for the national pension regulatory authority to decide on granting services regarding participation as well as retirement pensions due to inability to work. There are guidelines regarding the content of medical reports. It is also generally accepted that the evaluation of functioning is an essential component of them. However, it is still an open question to what extent the standardisation and the objectiveness of medical reports can be improved. The ICF (International Classification of Functioning, Disability and Health) is a framework as well as a common language for describing functioning and disability. ICF Core Sets are lists of disease-specific relevant ICF categories and can be a useful practicable tool for medical reports for national pension insurance. They could support the standardization of the medical reports. The aim of this planned project is to examine whether the ICF Core Sets for low back pain and chronic widespread pain could serve as a useful basis for medical reports for national pension insurance regarding the patients suffering low back pain or chronic widespread pain. Six hundred medical reports from patients with low back pain or chronic widespread pain, respectively, will be translated into the language of the ICF using a retrospective qualitative study design. For this translation ('linking') process specialised physicians from the national pension insurance and members of the Institute for Health and Rehabilitations Science will be trained to use established linking rules. STATE OF THE PROJECT: Currently, a total of 244 medical reports from the national pension insurance with the health conditions low back pain or chronic widespread pain were selected by members of the national pension insurance. The medical reports are anonymised in different federal states according to the appropriate requirements. The first 10 medical reports have already being analysed. First analyses show that the structure of medical reports varies enormously. Therefore a comparison of the content without having a common basis is hardly possible. This demonstrates the importance of the project and the possible usefulness of the ICF and the ICF Core Sets for structuring the content of medical reports for the national pension insurance.

  18. Low Back Pain in 17 Countries, a Rasch Analysis of the ICF Core Set for Low Back Pain

    ERIC Educational Resources Information Center

    Roe, Cecilie; Bautz-Holter, Erik; Cieza, Alarcos

    2013-01-01

    Previous studies indicate that a worldwide measurement tool may be developed based on the International Classification of Functioning Disability and Health (ICF) Core Sets for chronic conditions. The aim of the present study was to explore the possibility of constructing a cross-cultural measurement of functioning for patients with low back pain…

  19. Comparing contents of outcome measures in cerebral palsy using the International Classification of Functioning (ICF-CY): a systematic review.

    PubMed

    Schiariti, Veronica; Klassen, Anne F; Cieza, Alarcos; Sauve, Karen; O'Donnell, Maureen; Armstrong, Robert; Mâsse, Louise C

    2014-01-01

    The International Classification of Functioning children and youth version (ICF-CY) provides a universal framework for defining and classifying functioning and disability in children worldwide. To facilitate the application of the ICF in practice, ICF based-tools like the "ICF Core Sets" are being developed. In the context of the development of the ICF-CY Core Sets for children with Cerebral Palsy (CP), the aims of this study were as follows: to identify and compare the content of outcome measures used in studies of children with CP using the ICF-CY coding system; and to describe the most frequently addressed areas of functioning in those studies. We searched multiple databases likely to capture studies involving children with CP from January 1998 to March 2012. We included all English language articles that studied children aged 2-18 years and described an interventional or observational study. Constructs of the outcome measures identified in studies were linked to the ICF-CY by two trained professionals. We found 231 articles that described 238 outcome measures. The outcome measures contained 2193 concepts that were linked to the ICF-CY and covered 161 independent ICF-CY categories. Out of the 161 categories, 53 (33.5%) were related to body functions, 75 (46%) were related to activities/participation, 26 (16.1%) were related to environmental factors, and 7 (4.3%) were related to body structures. This systematic review provides information about content of measures that may guide researchers and clinicians in their selection of an outcome measure for use in a study and/or clinical practice with children with CP. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  20. A transversal multicenter study assessing functioning, disability and environmental factors with the comprehensive ICF core set for low back pain in Brazil.

    PubMed

    Riberto, M; Chiappetta, L M; Lopes, K A; Chiappetta, L R

    2014-04-01

    Low back pain is a leading cause of disability in Brazil. The multiple aspects of disability in these patients require comprehensive tools for their assessment. The International Classification of Functioning, Disability, and Health (ICF) core set for low back pain is designed to comprehensively describe the experience of such patients with their functioning. This study aimed to describe functioning and contextual factors and to empirically validate the ICF core set for low back pain. Cross sectional study. Three outpatient clinics in Manaus, Maceio and São Paulo, Brazil. Population. 135 low back pain outpatients under rehabilitation. Data concerning diagnosis, personal features, and the 78 ICF core set categories for low back pain were collected from clinical charts, physical examinations, tests, and interviews with patients from rehabilitation services in three parts of Brazil. 7.7% of the categories (6 body functions and 10 activity and participation) were affected in less than 20% of the sample, and were thus considered not validated. Pain and other sensations related to the musculoskeletal system were the body most frequently impaired functions. Mobility and domestic life were the chapters of activity and limitation most often described as limited. All environmental factors were qualified as either facilitators or barriers and acted as modulators of disability. The comprehensive ICF core sets for low back pain can be used to describe the living experience of such individuals, although efforts to make it operational and enhance the reproducibility of the results are needed to warrant its reliable routine use. This study highlights the importance of a complete assessment of chronic low back pain and demonstrate the need for multidisciplinary approach.

  1. Employing the International Classification of Functioning, Disability and Health framework to capture user feedback in the design and testing stage of development of home-based arm rehabilitation technology.

    PubMed

    Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andrew; O'Connor, Rory; Levesley, Martin

    2016-01-01

    The purpose of this study was to evaluate the International Classification of Functioning, Disability and Health (ICF) as a framework to ensure that key aspects of user feedback are identified in the design and testing stages of development of a home-based upper limb rehabilitation system. Seventeen stroke survivors with residual upper limb weakness, and seven healthcare professionals with expertise in stroke rehabilitation, were enrolled in the user-centered design process. Through semi-structured interviews, they provided feedback on the hardware, software and impact of a home-based rehabilitation device to facilitate self-managed arm exercise. Members of the multidisciplinary clinical and engineering research team, based on previous experience and existing literature in user-centred design, developed the topic list for the interviews. Meaningful concepts were extracted from participants' interviews based on existing ICF linking rules and matched to categories within the ICF Comprehensive Core Set for stroke. Most of the interview concepts (except personal factors) matched the existing ICF Comprehensive Core Set categories. Personal factors that emerged from interviews e.g. gender, age, interest, compliance, motivation, choice and convenience that might determine device usability are yet to be categorised within the ICF framework and hence could not be matched to a specific Core Set category.

  2. An International Clinical Study of Ability and Disability in Autism Spectrum Disorder Using the WHO-ICF Framework.

    PubMed

    Mahdi, Soheil; Albertowski, Katja; Almodayfer, Omar; Arsenopoulou, Vaia; Carucci, Sara; Dias, José Carlos; Khalil, Mohammad; Knüppel, Ane; Langmann, Anika; Lauritsen, Marlene Briciet; da Cunha, Graccielle Rodrigues; Uchiyama, Tokio; Wolff, Nicole; Selb, Melissa; Granlund, Mats; de Vries, Petrus J; Zwaigenbaum, Lonnie; Bölte, Sven

    2018-06-01

    This is the fourth international preparatory study designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF-CY) Core Sets for Autism Spectrum Disorder (ASD). Examine functioning of individuals diagnosed with ASD as documented by the ICF-CY in a variety of clinical settings. A cross-sectional study was conducted, involving 11 units from 10 countries. Clinical investigators assessed functioning of 122 individuals with ASD using the ICF-CY checklist. In total, 139 ICF-CY categories were identified: 64 activities and participation, 40 body functions and 35 environmental factors. The study results reinforce the heterogeneity of ASD, as evidenced by the many functional and contextual domains impacting on ASD from a clinical perspective.

  3. Generic patient-reported outcomes in child health research: a review of conceptual content using World Health Organization definitions.

    PubMed

    Fayed, Nora; de Camargo, Olaf Kraus; Kerr, Elizabeth; Rosenbaum, Peter; Dubey, Ankita; Bostan, Cristina; Faulhaber, Markus; Raina, Parminder; Cieza, Alarcos

    2012-12-01

    Our aims were to (1) describe the conceptual basis of popular generic instruments according to World Health Organization (WHO) definitions of functioning, disability, and health (FDH), and quality of life (QOL) with health-related quality of life (HRQOL) as a subcomponent of QOL; (2) map the instruments to the International Classification of Functioning, Disability and Health (ICF); and (3) provide information on how the analyzed instruments were used in the literature. This should enable users to make valid choices about which instruments have the desired content for a specific context or purpose. Child health-based literature over a 5-year period was reviewed to find research employing health status and QOL/HRQOL instruments. WHO definitions of FDH and QOL were applied to each item of the 15 most used instruments to differentiate measures of FDH and QOL/HRQOL. The ICF was used to describe the health and health-related content (if any) in those instruments. Additional aspects of instrument use were extracted from these articles. Many instruments that were used to measure QOL/HRQOL did not reflect WHO definitions of QOL. The ICF domains within instruments were highly variable with respect to whether body functions, activities and participation, or environment were emphasized. There is inconsistency among researchers about how to measure HRQOL and QOL. Moreover, when an ICF content analysis is applied, there is variability among instruments in the health components included and emphasized. Reviewing content is important for matching instruments to their intended purpose. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  4. Investigating inertial confinement fusion target fuel conditions through x-ray spectroscopya)

    NASA Astrophysics Data System (ADS)

    Hansen, Stephanie B.

    2012-05-01

    Inertial confinement fusion (ICF) targets are designed to produce hot, dense fuel in a neutron-producing core that is surrounded by a shell of compressing material. The x-rays emitted from ICF plasmas can be analyzed to reveal details of the temperatures, densities, gradients, velocities, and mix characteristics of ICF targets. Such diagnostics are critical to understand the target performance and to improve the predictive power of simulation codes.

  5. The selection of core International Classification of Functioning, Disability, and Health (ICF) categories for patient-reported outcome measurement in spine trauma patients-results of an international consensus process.

    PubMed

    Sadiqi, Said; Lehr, A Mechteld; Post, Marcel W; Jacobs, Wilco C H; Aarabi, Bizhan; Chapman, Jens R; Dunn, Robert N; Dvorak, Marcel F; Fehlings, Michael G; Rajasekaran, S; Vialle, Luiz R; Vaccaro, Alexander R; Oner, F Cumhur

    2016-08-01

    There is no outcome instrument specifically designed and validated for spine trauma patients without complete paralysis, which makes it difficult to compare outcomes of different treatments of the spinal column injury within and between studies. The paper aimed to report on the evidence-based consensus process that resulted in the selection of core International Classification of Functioning, Disability, and Health (ICF) categories, as well as the response scale for use in a universal patient-reported outcome measure for patients with traumatic spinal column injury. The study used a formal decision-making and consensus process. The sample includes patients with a primary diagnosis of traumatic spinal column injury, excluding completely paralyzed and polytrauma patients. The wide array of function and health status of patients with traumatic spinal column injury was explored through the identification of all potentially meaningful ICF categories. A formal decision-making and consensus process integrated evidence from four preparatory studies. Three studies aimed to identify relevant ICF categories from three different perspectives. The research perspective was covered by a systematic literature review identifying outcome measures focusing on the functioning and health of spine trauma patients. The expert perspective was explored through an international web-based survey among spine surgeons from the five AOSpine International world regions. The patient perspective was investigated in an international empirical study. A fourth study investigated various response scales for their potential use in the future universal outcome instrument. This work was supported by AOSpine. AOSpine is a clinical division of the AO Foundation, an independent medically guided non-profit organization. The AOSpine Knowledge Forums are pathology-focused working groups acting on behalf of AOSpine in their domain of scientific expertise. Combining the results of the preparatory studies, the list of ICF categories presented at the consensus conference included 159 different ICF categories. Based on voting and discussion, 11 experts from 6 countries selected a total of 25 ICF categories as core categories for patient-reported outcome measurement in adult traumatic spinal column injury patients (9 body functions, 14 activities and participation, and 2 environmental factors). The experts also agreed to use the Numeric Rating Scale 0-100 as response scale in the future universal outcome instrument. A formal consensus process integrating evidence and expert opinion led to a set of 25 core ICF categories for patient-reported outcome measurement in adult traumatic spinal column injury patients, as well as the response scale for use in the future universal disease-specific outcome instrument. The adopted core ICF categories could also serve as a benchmark for assessing the content validity of existing and future outcome instruments used in this specific patient population. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Assessment of functional outcomes in patients with head and neck cancer according to the International Classification of Functioning, Disability and Health Core Sets from the perspective of the multi-professional team: results of 4 Delphi surveys.

    PubMed

    Kirschneck, Michaela; Sabariego, Carla; Singer, Susanne; Tschiesner, Uta

    2014-07-01

    The International Classification of Functioning, Disability and Health Core Set for Head and Neck Cancer (ICF-HNC) covers the typical spectrum of problems in functioning in head and neck cancer. This study is part of a multistep process to develop practical guidelines in Germany. The purpose of this study was to identify instruments for the assessment of functioning using the ICF-HNC as reference. Four Delphi surveys with physicians, physiotherapists, psychologists, and social workers were performed to identify which aspects of the ICF-HNC are being treated and which assessment tools are recommended for the assessment of functioning. Ninety-seven percent categories of the ICF-HNC were treated by healthcare professionals participating in the current study. Altogether, 33 assessment tools were recommended for therapy monitoring, food intake, pain, further organic problems/laboratory tests, and psychosocial areas. Although the ICF-HNC is being currently implemented by the head and neck cancer experts, several areas are not covered regularly. Additionally, validated tools were rarely recommended. Copyright © 2013 Wiley Periodicals, Inc.

  7. A comprehensive scoping review of ability and disability in ADHD using the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY).

    PubMed

    de Schipper, Elles; Lundequist, Aiko; Wilteus, Anna Löfgren; Coghill, David; de Vries, Petrus J; Granlund, Mats; Holtmann, Martin; Jonsson, Ulf; Karande, Sunil; Levy, Florence; Al-Modayfer, Omar; Rohde, Luis; Tannock, Rosemary; Tonge, Bruce; Bölte, Sven

    2015-08-01

    This is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Attention Deficit Hyperactivity Disorder (ADHD). The objective here was to use a comprehensive scoping review approach to identify the concepts of functional ability and disability used in the scientific ADHD literature and link these to the nomenclature of the ICF-CY. Systematic searches were conducted using Medline/PubMed, PsycINFO, ERIC and Cinahl, to extract the relevant concepts of functional ability and disability from the identified outcome studies of ADHD. These concepts were then linked to ICF-CY by two independent researchers using a standardized linking procedure. Data from identified studies were analysed until saturation of ICF-CY categories was reached. Eighty studies were included in the final analysis. Concepts contained in these studies were linked to 128 ICF-CY categories. Of these categories, 68 were considered to be particularly relevant to ADHD (i.e., identified in at least 5 % of the studies). Of these, 32 were related to Activities and participation, 31 were related to Body functions, and five were related to environmental factors. The five most frequently identified categories were school education (53 %), energy and drive functions (50 %), psychomotor functions (50 %), attention functions (49 %), and emotional functions (45 %). The broad variety of ICF-CY categories identified in this study underlines the necessity to consider ability and disability in ADHD across all dimensions of life, for which the ICF-CY provides a valuable and universally applicable framework. These results, in combination with three additional preparatory studies (expert survey, focus groups, clinical study), will provide a scientific basis to define the ICF Core Sets for ADHD for multi-purpose use in basic and applied research, and every day clinical practice.

  8. The impact of age and gender on the ICF-based assessment of chronic low back pain.

    PubMed

    Fehrmann, Elisabeth; Kotulla, Simone; Fischer, Linda; Kienbacher, Thomas; Tuechler, Kerstin; Mair, Patrick; Ebenbichler, Gerold; Paul, Birgit

    2018-01-12

    To evaluate the impact of age and gender on the international classification of functioning, disability and health (ICF)-based assessment for chronic low back pain. Two hundred forty-four chronic low back pain patients (52% female) with a mean age of 49 years (SD =17.64) were interviewed with the comprehensive ICF core set for activities and participation, and environmental factors. After conducting explorative factor analysis, the impact of age and gender on the different factors was analyzed using analyzes of variances. Results revealed that older patients experienced more limitations within "self-care and mobility" and "walking" but less problems with "transportation" compared to younger patients. Older or middle-aged low back pain patients further perceived more facilitation through "architecture and products for communication", "health services", and "social services and products for mobility" than younger patients. Regarding gender differences, women reported more restriction in "housework" than men. An interaction effect between age and gender was found for "social activities and recreation" with young male patients reporting the highest impairment. The study demonstrated that the comprehensive ICF core set classification for chronic low back pain is influenced by age and gender. This impact is relevant for ICF-based assessments in clinical practice, and should be considered in intervention planning for rehabilitative programs. Implications for rehabilitation It is important to consider age and gender differences when classifying with the ICF. The intervention planning based on the ICF should focus on improvement of bodily functioning and mobility in older patients, facilitation of household activities in women, consideration of work-life balance and recreation (e.g., through mindfulness based stress reduction), and reduction of dissatisfaction with rehabilitation in younger patients. It is important to offer patients the opportunity to participate in intervention planning based on the ICF. For intervention planning professionals should bear in mind the resource-oriented approach of the ICF (e.g., facilitation through environmental factors), and a collaboration with other professionals.

  9. Measuring body structures and body functions from the International Classification of Functioning, Disability, and Health perspective: considerations for biomedical parameters in spinal cord injury research.

    PubMed

    Eriks-Hoogland, Inge E; Brinkhof, Martin W G; Al-Khodairy, Abdul; Baumberger, Michael; Brechbühl, Jörg; Curt, Armin; Mäder, Mark; Stucki, Gerold; Post, Marcel W M

    2011-11-01

    The aims of this study were to provide a selection of biomedical domains based on the comprehensive International Classification of Functioning, Disability, and Health (ICF) core sets for spinal cord injury (SCI) and to present an overview of the corresponding measurement instruments. Based on the Biomedical Domain Set, the SCI literature, the International Spinal Cord Society international data sets, and the Spinal Cord Injury Rehabilitation Evidence project publications were used to derive category specifications for use in SCI research. Expert opinion was used to derive a priority selection. The same sources were used to determine candidate measurement instruments for the specification of body functions and body structures using an example, and guiding principles were applied to select the most appropriate biomedical measurement instrument(s) for use in an SCI research project. Literature searches were performed for 41 second-level ICF body functions categories and for four second-level ICF body structures categories. For some of these categories, only a few candidate measurement instruments were found with limited variation in the type of measurement instruments. An ICF-based measurement set for biomedical aspects of functioning with SCI was established. For some categories of the ICF core sets for SCI, there is a need to develop measurement instruments.

  10. Identification of relevant ICF categories for indication, intervention planning and evaluation of health resort programs: a Delphi exercise

    NASA Astrophysics Data System (ADS)

    Morita, E.; Weigl, M.; Schuh, A.; Stucki, G.

    2006-01-01

    Health resort programs have a long tradition, mainly in European countries and Japan. They rely on local resources and the physical environment, physical medicine interventions and traditional medicine to optimise functioning and health. Arguably because of the long tradition, there is only a limited number of high-quality studies that examine the effectiveness of health resort programs. Specific challenges to the evaluation of health resort programs are to randomise the holistic approach with a varying number of specific interventions but also the reliance on the effect of the physical environment. Reference standards for the planning and reporting of health resort studies would be highly beneficial. With the International Classification of Functioning Disability and Health (ICF), we now have such a standard that allows us to describe body functions and structures, activities and participation and interaction with environmental factors. A major challenge when applying the ICF in practice is its length. Therefore, the objective of this project was to identify the ICF categories most relevant for health resort programs. We conducted a consensus-building, three-round, e-mail survey using the Delphi technique. Based on the consensus of the experts, it was possible to come up with an ICF Core Set that can serve as reference standards for the indication, intervention planning and evaluation of health resort programs. This preliminary ICF Core Set should be tested in different regions and in subsets of health resort visitors with varying conditions.

  11. An international qualitative study of ability and disability in ADHD using the WHO-ICF framework.

    PubMed

    Mahdi, Soheil; Viljoen, Marisa; Massuti, Rafael; Selb, Melissa; Almodayfer, Omar; Karande, Sunil; de Vries, Petrus J; Rohde, Luis; Bölte, Sven

    2017-10-01

    This is the third in a series of four cross-cultural empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF(-CY) Core Sets for Attention-Deficit Hyperactivity Disorder (ADHD). To explore the perspectives of individuals diagnosed with ADHD, self-advocates, immediate family members and professional caregivers on relevant areas of impairment and functional abilities typical for ADHD across the lifespan as operationalized by the ICF(-CY). A qualitative study using focus group discussions or semi-structured interviews of 76 participants, divided into 16 stakeholder groups. Participants from five countries (Brazil, India, Saudi Arabia, South Africa and Sweden) were included. A deductive qualitative content analysis was conducted to extract meaningful functioning and disability concepts from verbatim material. Extracted concepts were then linked to ICF(-CY) categories by independent researchers using a standardized linking procedure. In total, 82 ICF(-CY) categories were identified, of which 32 were related to activities and participation, 25 to environmental factors, 23 to body functions and 2 to body structures. Participants also provided opinions on experienced positive sides to ADHD. A high level of energy and drive, creativity, hyper-focus, agreeableness, empathy, and willingness to assist others were the most consistently reported strengths associated with ADHD. Stakeholder perspectives highlighted the need to appraise ADHD in a broader context, extending beyond diagnostic criteria into many areas of ability and disability as well as environmental facilitators and barriers. This qualitative study, along with three other studies (comprehensive scoping review, expert survey and clinical study), will provide the scientific basis to define ICF(-CY) Core Sets for ADHD, from which assessment tools can be derived for use in clinical and research setting, as well as in health care administration.

  12. The effectiveness of rehabilitation on pain-free farming in agriculture workers with low back pain in India.

    PubMed

    Ganesh, Shankar; Chhabra, Deepak; Kumari, Nitika

    2016-10-17

    Studies have shown that farming is associated with many agricultural workers experiencing low back pain (LBP). The rehabilitation of these workers should facilitate their functioning, activities and level of participation in an adequate way. The objectives of this study were to identify the health components associated with LBP and to evaluate the effectiveness of the interventions in returning agricultural workers with LBP to their vocation using the International Classification of Function (ICF) -based tools. Thirty-one full time agricultural workers from 3 different Indian states were prospectively assessed using the ICF core set for LBP. ICF core sets permitted analysis of limitations of function from both the participant and rehabilitation team's perspectives. Each ICF category was rated using an ICF qualifier. The components identified were linked to the ICF categorical profile and assessment sheet. The clinicians identified the global, service program and cycle goals based on ICF. The participants' functioning was followed over a 4-month period. After intervention, the participants were able to undergo their routine activities without increases in pain. However, on returning to active farming, participants noted few improvements in the components d410 (changing basic body position), d415 (maintaining body position), d430 (lifting and carrying objects), d465 (moving around using equipment), d850 (remunerative employment) and d859 (work and employment, other specified and unspecified). The results of the study conclude that the current interventions for LBP are not effective in returning agriculture workers with LBP in India to pain-free farming. There is an urgent need to individualize the health needs of agriculture workers.

  13. Ability and Disability in Autism Spectrum Disorder: A Systematic Literature Review Employing the International Classification of Functioning, Disability and Health-Children and Youth Version.

    PubMed

    de Schipper, Elles; Lundequist, Aiko; Coghill, David; de Vries, Petrus J; Granlund, Mats; Holtmann, Martin; Jonsson, Ulf; Karande, Sunil; Robison, John E; Shulman, Cory; Singhal, Nidhi; Tonge, Bruce; Wong, Virginia C N; Zwaigenbaum, Lonnie; Bölte, Sven

    2015-12-01

    This study is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The objective was to use a systematic review approach to identify, number, and link functional ability and disability concepts used in the scientific ASD literature to the nomenclature of the ICF-CY (Children and Youth version of the ICF, covering the life span). Systematic searches on outcome studies of ASD were carried out in Medline/PubMed, PsycINFO, ERIC and Cinahl, and relevant functional ability and disability concepts extracted from the included studies. These concepts were then linked to the ICF-CY by two independent researchers using a standardized linking procedure. New concepts were extracted from the studies until saturation of identified ICF-CY categories was reached. Seventy-one studies were included in the final analysis and 2475 meaningful concepts contained in these studies were linked to 146 ICF-CY categories. Of these, 99 categories were considered most relevant to ASD (i.e., identified in at least 5% of the studies), of which 63 were related to Activities and Participation, 28 were related to Body functions, and 8 were related to Environmental factors. The five most frequently identified categories were basic interpersonal interactions (51%), emotional functions (49%), complex interpersonal interactions (48%), attention functions (44%), and mental functions of language (44%). The broad variety of ICF-CY categories identified in this study reflects the heterogeneity of functional differences found in ASD--both with respect to disability and exceptionality--and underlines the potential value of the ICF-CY as a framework to capture an individual's functioning in all dimensions of life. The current results in combination with three additional preparatory studies (expert survey, focus groups, and clinical study) will provide the scientific basis for defining the ICF Core Sets for ASD for multipurpose use in basic and applied research and every day clinical practice of ASD. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

  14. Examining the similarities and differences of OMERACT core sets using the ICF: first step towards an improved domain specification and development of an item pool to measure functioning and health.

    PubMed

    Escorpizo, Reuben; Boers, Maarten; Stucki, Gerold; Boonen, Annelies

    2011-08-01

    To contribute to the discussion on a common approach for domain selection in the Outcomes in Rheumatology Clinical Trials (OMERACT) process. First, this article reports on the consistency in the selection and names of the domains of the current OMERACT core set, and next on the comparability of the specifications of concepts that are relevant within the domains. For this purpose, a convenience sample of 4 OMERACT core sets was used: rheumatoid arthritis (RA), psoriatic arthritis (PsA), longitudinal observational studies (LOS) in rheumatology, and ankylosing spondylitis (AS). Domains from the different core sets were compared directly. To be able to compare the specific content of the domains, the concepts contained in the questionnaires that were considered or proposed to measure the domains were identified and linked to the category of the International Classification of Functioning, Disability, and Health (ICF) that best fit that construct. Large differences in the domains, and lack of domain definitions, were noted among the 4 OMERACT core sets. When comparing the concepts in the questionnaires that represent the domains, core sets differed also in the number and type of constructs that were addressed within each of the domains. Especially for the specification of the concepts within the domains Discomfort and Disability, the ICF proved to be useful as external reference to classify the different constructs. Our exercise suggests that the OMERACT process could benefit from a standardized approach to select, define, and specify domains, and demonstrated that the ICF is useful for further classification of the more specific concepts of "what to measure" within the domains. A clear definition and classification of domains and their specification can be useful as a starting point to build a pool of items that could then be used to develop new instruments to assess functioning and health for rheumatological conditions.

  15. Functioning and disability in autism spectrum disorder: A worldwide survey of experts

    PubMed Central

    de Schipper, Elles; Mahdi, Soheil; de Vries, Petrus; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Almodayfer, Omar; Shulman, Cory; Tonge, Bruce; Wong, Virginia V.C.N.; Zwaigenbaum, Lonnie

    2016-01-01

    Objective: This study is the second of four to prepare International Classification of Functioning, Disability and Health (ICF; and Children and Youth version, ICF(‐CY)) Core Sets for Autism Spectrum Disorder (ASD).The objective of this study was to survey the opinions and experiences of international experts on functioning and disability in ASD. Methods: Using a protocol stipulated by the World Health Organization (WHO) and monitored by the ICF Research Branch, an email‐based questionnaire was circulated worldwide among ASD experts, and meaningful functional ability and disability concepts were extracted from their responses. These concepts were then linked to the ICF(‐CY) by two independent researchers using a standardized linking procedure. Results: N = 225 experts from 10 different disciplines and all six WHO‐regions completed the survey. Meaningful concepts from the responses were linked to 210 ICF(‐CY) categories. Of these, 103 categories were considered most relevant to ASD (i.e., identified by at least 5% of the experts), of which 37 were related to Activities and Participation, 35 to Body functions, 22 to Environmental factors, and 9 to Body structures. A variety of personal characteristics and ASD‐related functioning skills were provided by experts, including honesty, loyalty, attention to detail and creative talents. Reported gender differences in ASD comprised more externalizing behaviors among males and more internalizing behaviors in females. Conclusion: The ICF(‐CY) categories derived from international expert opinions indicate that the impact of ASD on functioning extends far beyond core symptom domains. Autism Res 2016, 9: 959–969. © 2016 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research PMID:26749373

  16. A Global Oral Health Survey of professional opinion using the International Classification of Functioning, Disability and Health.

    PubMed

    Dougall, Alison; Molina, Gustavo F; Eschevins, Caroline; Faulks, Denise

    2015-06-01

    The concept of oral health is frequently reduced to the absence of disease, despite existing conceptual models exploring the wider determinants of oral health and quality of life. The International Classification of Functioning, Disability and Health (ICF) (WHO) is designed to qualify functional, social and environmental aspects of health. This survey aimed to reach a consensual description of adult oral health, derived from the ICF using international professional opinion. The Global Oral Health Survey involved a two-round, online survey concerning factors related to oral health including functioning, participation and social environment. Four hundred eighty-six oral health professionals from 74 countries registered online. Professionals were pooled into 18 groups of six WHO world regions and three professional groups. In a randomised stratification process, eight professionals from each pool (n=144) completed the survey. The first round consisted of eight open-ended questions. Open expression replies were analysed for meaningful concepts and linked using established rules to the ICF. In Round 2, items were rated for their relevance to oral health (88% response rate). Eighty-nine ICF items and 30 other factors were considered relevant by at least 80% of participants. International professionals reached consensus on a holistic description of oral health, which could be qualified and quantified using the ICF. These results represent the first step towards developing an ICF Core Set in Oral Health, which would provide a practical tool for reporting outcome measures in clinical practice, for research and epidemiology, and for the improvement of interdisciplinary communication regarding oral health. Professional consensus reached in this survey is the foundation stone for developing an ICF Core Set in Oral Health, allowing the holistic aspects of oral health to be qualified and quantified. This tool is necessary to widen our approach to clinical decision making, measurement of clinical outcomes, research and epidemiology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Using the International Classification of Functioning, Disability and Health (ICF) to describe children referred to special care or paediatric dental services.

    PubMed

    Faulks, Denise; Norderyd, Johanna; Molina, Gustavo; Macgiolla Phadraig, Caoimhin; Scagnet, Gabriela; Eschevins, Caroline; Hennequin, Martine

    2013-01-01

    Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child's capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child's real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ± 3.6 yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were 'Intellectual functions', 'High-level cognitive functions', and 'Attention functions'. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including 'Handling stress', 'Caring for body parts', 'Looking after one's health' and 'Speaking'. In the Environment domain, facilitating items included 'Support of friends', 'Attitude of friends' and 'Support of immediate family'. One item was reported as an environmental barrier - 'Societal attitudes'. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical study might be used to develop an ICF-CY Core Set for Oral Health - a holistic but practical tool for clinical and epidemiological use.

  18. European initiative for the application of the International Classification of Functioning, Disability and Health: development of Clinical Assessment Schedules for specified rehabilitation services.

    PubMed

    Prodinger, Birgit; Scheel-Sailer, Anke; Escorpizo, Reuben; Stucki, Gerold

    2017-04-01

    Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. UEMS PRM Workshop in Nottwil, Switzerland, January 2016. PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds. Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services. The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted. All groups deliberated on this topic; however, no conclusive statement was presented yet. The groups recognized a need for a systematic effort to identify data collection tools currently used. CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for improving data collection on people's functioning.

  19. Physiotherapy in rheumatoid arthritis: development of a practice guideline.

    PubMed

    Hurkmans, E J; van der Giesen, F J; Bloo, H; Boonman, D C; van der Esch, M; Fluit, M; Hilberdink, W K; Peter, W F; van der Stegen, H P; Veerman, E A; Verhoef, J; Vermeulen, H M; Hendriks, H M; Schoones, J W; Vliet Vlieland, T P

    2011-01-01

    To improve the quality of the physiotherapy management in patients with rheumatoid arthritis (RA) a Dutch practice guideline, based on current scientific evidence and best practice, was developed. This guideline comprised all elements of a structured approach (assessment, treatment and evaluation) and was based on the Internatio-nal Classification of Functioning, disability and Health (ICF) and the ICF core sets for RA. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 10 experts from different professional backgrounds resulting in the final guideline. In total 7 topics were selected. For the initial assessment, three recommendations were made. Based on the ICF core sets for RA a list of health problems relevant for the physiotherapist was made and completed with red flags and points of attention. Concerning treatment, three recommendations were formulated; both exercise therapy and education on physiotherapy were recommended, whereas passive interventions (delivery of heat or cold, mechanical, electric and electromagnetic energy, massage, passive mobilization/manipulation and balneotherapy) were neither recommended nor discouraged. For treatment evaluation at the level of activities and participation, the Health Assessment Questionnaire was recommended. For evaluating specific body structures and functions the handheld dynamometer, 6-minute walk test or Ästrand bicycle test (including Borg-scale for rating the perceived exertion), Escola Paulista de Medicina Range of Motion Scale and a Visual Analog Scale for pain and morning stiffness were recommended. This physiotherapy practice guideline for RA included seven recommendations on the initial assessment, treatment and evaluation, which were all based on the ICF and the ICF Core Set for RA. The implementation of the guideline in clinical practice needs further evaluation.

  20. Validation of the comprehensive ICF core sets for diabetes mellitus:a Malaysian perspective.

    PubMed

    Abdullah, Mohd Faudzi; Nor, Norsiah Mohd; Mohd Ali, Siti Zubaidah; Ismail Bukhary, Norizzati Bukhary; Amat, Azlin; Latif, Lydia Abdul; Hasnan, Nazirah; Omar, Zaliha

    2011-04-01

    Diabetes mellitus (DM) is a chronic disease that is prevalent in many countries. The prevalence of DM is on the rise, and its complications pose a heavy burden on the healthcare systems and on the patients' quality of life worldwide. This is a multicentre, cross-sectional study involving 5 Health Clinics conducted by Family Medicine Specialists in Malaysia. Convenience sampling of 100 respondents with DM were selected. The International Classifi cation of Functioning, Disability and Health (ICF) based measures were collected using the Comprehensive Core Set for DM. SF-36 and self-administered forms and comorbidity questionnaire (SCQ) were also used. Ninety-seven percent had Type 2 DM and 3% had Type 1 DM. The mean period of having DM was 6 years. Body functions related to physical health including exercise tolerance (b455), general physical endurance (b4550), aerobic capacity (b4551) and fatiguability (b4552) were the most affected. For body structures, the structure of pancreas (s550) was the most affected. In the ICF component of activities and participation, limitation in sports (d9201) was the highest most affected followed by driving (d475), intimate relationships (d770), handling stress and other psychological demands (d240) and moving around (d455). Only 7% (e355 and e450) in the environmental category were documented as being a relevant factor by more than 90% of the patients. The content validity of the comprehensive ICF Core set DM for Malaysian population were identified and the results show that physical and mental functioning were impaired in contrast to what the respondents perceived as leading healthy lifestyles.

  1. Using the International Classification of Functioning, Disability and Health in Assessment and Intervention of School-Aged Children With Language Impairments.

    PubMed

    Westby, Carol; Washington, Karla N

    2017-07-26

    The aim of this tutorial is to support speech-language pathologists' (SLPs') application of the International Classification of Functioning, Disability and Health (ICF) in assessment and treatment practices with children with language impairment. This tutorial reviews the framework of the ICF, describes the implications of the ICF for SLPs, distinguishes between students' capacity to perform a skill in a structured context and the actual performance of that skill in naturalistic contexts, and provides a case study of an elementary school child to demonstrate how the principles of the ICF can guide assessment and intervention. The Scope of Practice and Preferred Practice documents for the American Speech-Language-Hearing Association identify the ICF as the framework for practice in speech-language pathology. This tutorial will facilitate clinicians' ability to identify personal and environmental factors that influence students' skill capacity and skill performance, assess students' capacity and performance, and develop impairment-based and socially based language goals linked to Common Core State Standards that build students' language capacity and their communicative performance in naturalistic contexts.

  2. Using the International Classification of Functioning, Disability and Health (ICF) to Describe Children Referred to Special Care or Paediatric Dental Services

    PubMed Central

    Faulks, Denise; Norderyd, Johanna; Molina, Gustavo; Macgiolla Phadraig, Caoimhin; Scagnet, Gabriela; Eschevins, Caroline; Hennequin, Martine

    2013-01-01

    Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child’s capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child’s real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ±3.6yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were ‘Intellectual functions’, ‘High-level cognitive functions’, and ‘Attention functions’. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including ‘Handling stress’, ‘Caring for body parts’, ‘Looking after one’s health’ and ‘Speaking’. In the Environment domain, facilitating items included ‘Support of friends’, ‘Attitude of friends’ and ‘Support of immediate family’. One item was reported as an environmental barrier – ‘Societal attitudes’. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical study might be used to develop an ICF-CY Core Set for Oral Health - a holistic but practical tool for clinical and epidemiological use. PMID:23614000

  3. An international qualitative study of functioning in autism spectrum disorder using the World Health Organization international classification of functioning, disability and health framework

    PubMed Central

    Mahdi, Soheil; Viljoen, Marisa; Yee, Tamara; Selb, Melissa; Singhal, Nidhi; Almodayfer, Omar; Granlund, Mats; de Vries, Petrus J.; Zwaigenbaum, Lonnie

    2017-01-01

    This is the third in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The present study aimed to describe functioning in ASD (as operationalized by the ICF) derived from the perspectives of diagnosed individuals, family members, and professionals. A qualitative study using focus groups and semi‐structured interviews were conducted with 19 stakeholder groups (N = 90) from Canada, India, Saudi Arabia, South Africa, and Sweden. Meaningful concepts from the focus groups and individual interviews were linked to ICF categories using a deductive qualitative approach with standardized linking procedures. The deductive qualitative content analysis yielded meaningful functioning concepts that were linked to 110 ICF categories across all four ICF components. Broad variation of environmental factors and activities and participation categories were identified in this study, while body functions consisted mainly of mental functions. Body structures were sparsely mentioned by the participants. Positive aspects of ASD included honesty, attention to detail, and memory. The experiences provided by international stakeholders support the need to understand individuals with ASD in a broader perspective, extending beyond diagnostic criteria into many areas of functioning and environmental domains. This study is part of a larger systematic effort that will provide the basis to define ICF Core Sets for ASD, from which assessment tools can be generated for use in clinical practice, research, and health care policy making. Autism Res 2018, 11: 463–475. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary The study findings support the need to understand the living experiences of individuals with Autism Spectrum Disorder (ASD) from a broader perspective, taking into account many areas of an individual's functioning and environment. The ICF can serve as foundation for exploring these living experiences more extensively by offering tools that enable wide variety of individual difficulties and strengths to be captured along with important environmental influences. As such, these tools can facilitate interventions that meet the needs and goals of the individual. PMID:29226604

  4. Fluorescence and absorption spectroscopy for warm dense matter studies and ICF plasma diagnostics

    NASA Astrophysics Data System (ADS)

    Hansen, Stephanie

    2017-10-01

    The burning core of an inertial confinement fusion (ICF) plasma at stagnation is surrounded by a shell of warm, dense matter whose properties are difficult both to model (due to a complex interplay of thermal, degeneracy, and strong coupling effects) and to diagnose (due to low emissivity and high opacity). We demonstrate a promising technique to study the warm dense shells of ICF plasmas based on the fluorescence emission of dopants or impurities in the shell material. This emission, which is driven by x-rays produced in the hot core, exhibits signature changes in response to compression and heating. High-resolution measurements of absorption and fluorescence features can refine our understanding of the electronic structure of material under high compression, improve our models of density-driven phenomena such as ionization potential depression and plasma polarization shifts, and help diagnose shell density, temperature, mass distribution, and residual motion in ICF plasmas at stagnation. Sandia National Laboratories is a multi-mission laboratory managed and operated by National Technology and Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA-0003525. This work was supported by the U.S. Department of Energy, Office of Science Early Career Research Program, Office of Fusion Energy Sciences under FWP-14-017426.

  5. Health promotion and education: application of the ICF in the US and Canada using an ecological perspective.

    PubMed

    Howard, David; Nieuwenhuijsen, Els R; Saleeby, Patricia

    2008-01-01

    Health promotion is an issue comprised of complex and multi-layered concepts that involves a process of enabling people to increase control over and improve their health. The aims and applications of the World Health Organization's International Classification of Functioning, Disability and Health (ICF), with its focus on components of functioning, activities and participation, and environmental factors are salient to health promotion and health education efforts. For individuals with or without disabilities, health promotion occurs within the community in which they reside and is influenced by a complex interaction of personal and environmental factors. The aim of this paper is to discuss how the ICF can be useful in enhancing social change through health promotion and health education for all people, in particular those with disabilities and chronic conditions. In doing so health promotion concepts and the ecological approach linked with the ICF, the relationship of social change and social support to the ICF, the potential role of the ICF for national and local (city) policies, and the role of health professionals in this process will be examined. Building on this body of knowledge, the authors recommend that future research should focus on the relationship between policies and the social participation of people with disabilities in the community, the use of ICF measurement tools to improve the indicators established by the National Organization on Disability, the development of a new ICF core set for community accessibility and inclusion, better interventions to enhance social support, and enhancing the role of professionals in health promotion for people with disabilities or chronic health conditions.

  6. Type C investigation of electrical fabrication projects in ICF Kaiser shops

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huckfeldt, R.A.

    1995-06-01

    A Type C Investigation Board was convened to investigate an electrical miswiring problem found during the operation of the electrical distribution trailer for the TWRS Rotary Mode Core Sampling Truck {number_sign}2. The trailer was designed by WHC and fabricated ICF KH on site for use in the Characterization Program. This problem resulted in a serious safety hazard since the support truck frame/chassis became electrically energized. This final report provides results of the ``Type C Investigation, Electrical Fabrication Projects in ICF KH Shops, June, 1995.`` It contains the investigation scope, executive summary, relevant facts, analysis, conclusions and corrective actions. DOE Ordermore » 5484.1, ``Environmental Protection, Safety and Health Protection Information Reporting Requirements,`` was followed in preparation of this report. Because the incident was electrical in nature and involved both Westinghouse Hanford Company and ICF Kaiser Hanford organizations, the board included members from both contractors and members with considerable electrical expertise.« less

  7. Fluorescence and absorption spectroscopy for warm dense matter studies and ICF plasma diagnostics

    NASA Astrophysics Data System (ADS)

    Hansen, S. B.; Harding, E. C.; Knapp, P. F.; Gomez, M. R.; Nagayama, T.; Bailey, J. E.

    2018-05-01

    The burning core of an inertial confinement fusion (ICF) plasma produces bright x-rays at stagnation that can directly diagnose core conditions essential for comparison to simulations and understanding fusion yields. These x-rays also backlight the surrounding shell of warm, dense matter, whose properties are critical to understanding the efficacy of the inertial confinement and global morphology. We show that the absorption and fluorescence spectra of mid-Z impurities or dopants in the warm dense shell can reveal the optical depth, temperature, and density of the shell and help constrain models of warm, dense matter. This is illustrated by the example of a high-resolution spectrum collected from an ICF plasma with a beryllium shell containing native iron impurities. Analysis of the iron K-edge provides model-independent diagnostics of the shell density (2.3 × 1024 e/cm3) and temperature (10 eV), while a 12-eV red shift in Kβ and 5-eV blue shift in the K-edge discriminate among models of warm dense matter: Both shifts are well described by a self-consistent field model based on density functional theory but are not fully consistent with isolated-atom models using ad-hoc density effects.

  8. Toward an International Classification of Functioning, Disability and Health clinical data collection tool: the Italian experience of developing simple, intuitive descriptions of the Rehabilitation Set categories.

    PubMed

    Selb, Melissa; Gimigliano, Francesca; Prodinger, Birgit; Stucki, Gerold; Pestelli, Germano; Iocco, Maurizio; Boldrini, Paolo

    2017-04-01

    As part of international efforts to develop and implement national models including the specification of ICF-based clinical data collection tools, the Italian rehabilitation community initiated a project to develop simple, intuitive descriptions of the ICF Rehabilitation Set, highlighting the core concept of each category in user-friendly language. This paper outlines the Italian experience in developing simple, intuitive descriptions of the ICF Rehabilitation Set as an ICF-based clinical data collection tool for Italy. Consensus process. Expert conference. Multidisciplinary group of rehabilitation professionals. The first of a two-stage consensus process involved developing an initial proposal for simple, intuitive descriptions of each ICF Rehabilitation Set category based on descriptions generated in a similar process in China. Stage two involved a consensus conference. Divided into three working groups, participants discussed and voted (vote A) whether the initially proposed descriptions of each ICF Rehabilitation Set category was simple and intuitive enough for use in daily practice. Afterwards the categories with descriptions considered ambiguous i.e. not simple and intuitive enough, were divided among the working groups, who were asked to propose a new description for the allocated categories. These proposals were then voted (vote B) on in a plenary session. The last step of the consensus conference required each working group to develop a new proposal for each and the same categories with descriptions still considered ambiguous. Participants then voted (final vote) for which of the three proposed descriptions they preferred. Nineteen clinicians from diverse rehabilitation disciplines from various regions of Italy participated in the consensus process. Three ICF categories already achieved consensus in vote A, while 20 ICF categories were accepted in vote B. The remaining 7 categories were decided in the final vote. The findings were discussed in light of current efforts toward developing strategies for ICF implementation, specifically for the application of an ICF-based clinical data collection tool, not only for Italy but also for the rest of Europe. Promising as minimal standards for monitoring the impact of interventions and for standardized reporting of functioning as a relevant outcome in rehabilitation.

  9. Beyond diagnosis: the Core Sets for persons with schizophrenia based on the World Health Organization's International Classification of Functioning, Disability, and Health.

    PubMed

    Gómez-Benito, Juana; Guilera, Georgina; Barrios, Maite; Rojo, Emilio; Pino, Oscar; Gorostiaga, Arantxa; Balluerka, Nekane; Hidalgo, María Dolores; Padilla, José Luis; Benítez, Isabel; Selb, Melissa

    2017-07-30

    Based on the International Classification of Functioning, Disability and Health (ICF), this paper presents the results of the process to develop the Comprehensive and Brief Core Sets for schizophrenia that allow to comprehensively describe functioning in persons with schizophrenia. Twenty health professionals from diverse backgrounds participated in a formal and iterative decision-making process during an international consensus conference to develop these Core Sets. The conference was carried out based on evidence gathered from four preparatory studies (systematic literature review, qualitative study, expert survey, and empirical study). The first step of this decision-making and consensus process comprised of discussions and voting in working groups and plenary sessions to develop the comprehensive version. The categories of the Comprehensive ICF Core Set for schizophrenia served as the basis for the second step -a ranking and cutoff procedure to decide on the brief version. Of the 184 candidate categories identified in the preparatory studies, 97 categories were included in the Comprehensive Core Set for schizophrenia. A total of 25 categories were selected to constitute the Brief Core Set. The formal decision-making and consensus process integrating evidence from four preparatory studies and expert opinion led to the first version of the Core Sets for schizophrenia. Comprehensive and Brief Core Sets for schizophrenia may provide a common language among different health professionals and researchers, and a basic international standard of what to measure, report, and assess the functioning of persons with schizophrenia. Implications for rehabilitation Schizophrenia is a chronic mental disorder that has a tremendous impact on functioning and daily life of persons living with the disorder. The International Classification of Functioning, Disability and Health (ICF) offers an internationally recognized standard for describing the functioning status of these individuals. The Core Sets for schizophrenia have potential use in supporting rehabilitation practice such as for planning mental health services and other interventions or defining rehabilitation goals, and documenting patient care. The Core Sets for schizophrenia may also be used to promote interdisciplinary coordination and facilitate communication between members of a multidisciplinary rehabilitation team. Rehabilitation research is another potential area of application of the Core Sets for schizophrenia. This is valuable, since rehabilitation research provides crucial evidence for optimizing rehabilitation practice.

  10. Adolescents with disabilities participate in the shopping mall: facilitators and barriers framed according to the ICF.

    PubMed

    Dahan-Oliel, Noémi; Shikako-Thomas, Keiko; Mazer, Barbara; Majnemer, Annette

    2016-10-01

    Community participation is restricted for youth with disabilities. The mall is an important gathering place where adolescents often socialise and develop community living skills, yet participation may be restricted. The aim of this study was to evaluate the facilitators and barriers to participation in a shopping mall through the perspectives of adolescents with disabilities. Semi-structured individual interviews were conducted with adolescents aged 12-19 years with a physical and/or sensory disability. Audio recordings were transcribed verbatim and coded following a template analysis using the International Classification of Functioning Disability and Health (ICF). Eleven youth (six females, mean age = 17.0 years) participated. Medical conditions included visual impairment, hearing impairment, cerebral palsy, hemiplegia, osteogenesis imperfecta and congenital amputations. Six themes were identified by the adolescents: what the shopping mall means to me, physical environment, transportation, social factors, attitudes and the person. The majority of themes mapped to the ICF's 'environmental factors'. Facilitators and barriers identified were either generic or disability-specific, implying that some modifications to shopping malls may be beneficial across disability types. Changes made to the physical, social and attitudinal environment are required to enable full participation of youth with disabilities within a shopping mall and other built environments of high public access. Implications for Rehabilitation The meaning of the shopping mall according to youth with disabilities includes socialisation, shopping, getting out of the home and employment. The majority of themes mapped to 'environmental factors' indicating that most obstacles to participation are caused by environmental barriers. Facilitators and barriers identified were either generic or disability-specific implying that some modifications to shopping malls may be beneficial across disability types. Changes made to the physical, social and attitudinal environment are required to enable full participation of youth with disabilities within a shopping mall.

  11. Fluorescence and absorption spectroscopy for warm dense matter studies and ICF plasma diagnostics

    DOE PAGES

    Hansen, Stephanie B.; Harding, Eric C.; Knapp, Patrick F.; ...

    2018-03-07

    The burning core of an inertial confinement fusion (ICF) plasma produces bright x-rays at stagnation that can directly diagnose core conditions essential for comparison to simulations and understanding fusion yields. These x-rays also backlight the surrounding shell of warm, dense matter, whose properties are critical to understanding the efficacy of the inertial confinement and global morphology. In this work, we show that the absorption and fluorescence spectra of mid-Z impurities or dopants in the warm dense shell can reveal the optical depth, temperature, and density of the shell and help constrain models of warm, dense matter. This is illustrated bymore » the example of a high-resolution spectrum collected from an ICF plasma with a beryllium shell containing native iron impurities. Lastly, analysis of the iron K-edge provides model-independent diagnostics of the shell density (2.3 × 10 24 e/cm 3) and temperature (10 eV), while a 12-eV red shift in Kβ and 5-eV blue shift in the K-edge discriminate among models of warm dense matter: Both shifts are well described by a self-consistent field model based on density functional theory but are not fully consistent with isolated-atom models using ad-hoc density effects.« less

  12. Describing the clinical reasoning process: application of a model of enablement to a pediatric case.

    PubMed

    Furze, Jennifer; Nelson, Kelly; O'Hare, Megan; Ortner, Amanda; Threlkeld, A Joseph; Jensen, Gail M

    2013-04-01

    Clinical reasoning is a core tenet of physical therapy practice leading to optimal patient care. The purpose of this case was to describe the outcomes, subjective experience, and reflective clinical reasoning process for a child with cerebral palsy using the International Classification of Functioning, Disability, and Health (ICF) model. Application of the ICF framework to a 9-year-old boy with spastic triplegic cerebral palsy was utilized to capture the interwoven factors present in this case. Interventions in the pool occurred twice weekly for 1 h over a 10-week period. Immediately post and 4 months post-intervention, the child made functional and meaningful gains. The family unit also developed an enjoyment of exercising together. Each individual family member described psychological, emotional, or physical health improvements. Reflection using the ICF model as a framework to discuss clinical reasoning can highlight important factors contributing to effective patient management.

  13. Development of the first disability index for inflammatory bowel disease based on the international classification of functioning, disability and health

    PubMed Central

    Peyrin-Biroulet, Laurent; Cieza, Alarcos; Sandborn, William J; Coenen, Michaela; Chowers, Yehuda; Hibi, Toshifumi; Kostanjsek, Nenad; Stucki, Gerold

    2011-01-01

    Objective The impact of inflammatory bowel disease (IBD) on disability remains poorly understood. The World Health Organization's integrative model of human functioning and disability in the International Classification of Functioning, Disability and Health (ICF) makes disability assessment possible. The ICF is a hierarchical coding system with four levels of details that includes over 1400 categories. The aim of this study was to develop the first disability index for IBD by selecting most relevant ICF categories that are affected by IBD. Methods Relevant ICF categories were identified through four preparatory studies (systematic literature review, qualitative study, expert survey and cross-sectional study), which were presented at a consensus conference. Based on the identified ICF categories, a questionnaire to be filled in by clinicians, called the ‘IBD disability index’, was developed. Results The four preparatory studies identified 138 second-level categories: 75 for systematic literature review (153 studies), 38 for qualitative studies (six focus groups; 27 patients), 108 for expert survey (125 experts; 37 countries; seven occupations) and 98 for cross-sectional study (192 patients; three centres). The consensus conference (20 experts; 17 countries) led to the selection of 19 ICF core set categories that were used to develop the IBD disability index: seven on body functions, two on body structures, five on activities and participation and five on environmental factors. Conclusions The IBD disability index is now available. It will be used in studies to evaluate the long-term effect of IBD on patient functional status and will serve as a new endpoint in disease-modification trials. PMID:21646246

  14. Comparison of subjective and objective assessments of outcome after traumatic brain injury using the International Classification of Functioning, Disability and Health (ICF).

    PubMed

    Koskinen, Sanna; Hokkinen, Eeva-Maija; Wilson, Lindsay; Sarajuuri, Jaana; Von Steinbüchel, Nicole; Truelle, Jean-Luc

    2011-01-01

    The aim is to examine two aspects of outcome after traumatic brain injury (TBI). Functional outcome was assessed by the Glasgow Outcome Scale - Extended (GOSE) and by clinician ratings, while health-related quality of life (HRQoL) was assessed by the Quality of Life after Brain Injury (QOLIBRI). The GOSE and the QOLIBRI were linked to the International Classification of Functioning, Disability and Health (ICF) to analyse their content. Functional outcome on ICF categories was assessed by rehabilitation clinicians in 55 participants with TBI and was compared to the participants' own judgements of their HRQoL. The QOLIBRI was linked to 42 and the GOSE to 57 two-level ICF categories covering 78% of the categories on the ICF brief core set for TBI. The closest agreement in the views of the professionals and the participants was found on the Physical Problems and Cognition scales of the QOLIBRI. The problems encountered after TBI are well covered by the QOLIBRI and the GOSE. They capture important domains that are not traditionally sufficiently documented, especially in the domains of interpersonal relationships, social and leisure activities, self and the environment. The findings indicate that they are useful and complementary outcome measures for TBI. In rehabilitation, they can serve as tools in assessment, setting meaningful goals and creating therapeutic alliance.

  15. Plasma photonics in ICF & HED conditions

    NASA Astrophysics Data System (ADS)

    Michel, Pierre; Turnbull, David; Divol, Laurent; Pollock, Bradley; Chen, Cecilia Y.; Tubman, Eleanor; Goyon, Clement S.; Moody, John D.

    2015-11-01

    Interactions between multiple high-energy laser beams and plasma can be used to imprint refractive micro-structures in plasmas via the lasers' ponderomotive force. For example, Inertial confinement fusion (ICF) experiments at the National Ignition Facility already rely on the use of plasma gratings to redirect laser light inside an ICF target and tune the symmetry of the imploded core. More recently, we proposed new concepts of plasma polarizer and waveplate, based on two-wave mixing schemes and laser-induced plasma birefringence. In this talk, we will present new experimental results showing the first demonstration of a fully tunable plasma waveplate, which achieved near-perfect circular laser polarization. We will discuss further prospects for novel ``plasma photonics'' concepts based on two- and four-wave mixing, such as optical switches, bandpass filters, anti-reflection blockers etc. These might find applications in ICF and HED experiments by allowing to manipulate the lasers directly in-situ (i.e. inside the targets), as well as for the design of high power laser systems. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  16. Reliability and Validity of the Turkish Version of the PedsQL 3.0 Cancer Module for 2- to 7-Year-Old and the PedsQL 4.0 Generic Core Scales for 5- to 7-Year-Old: The Hacettepe University Experience.

    PubMed

    Yıldız Kabak, Vesile; Yakut, Yavuz; Çetin, Mualla; Düger, Tülin

    2016-09-05

    The aim of this study was to investigate the reliability and validity of the Turkish version of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module for 2- to 7-year-old and the PedsQL 4.0 Generic Core Scales for 5- to 7-year-old in childhood cancer. The PedsQL 3.0 Cancer Module and PedsQL 4.0 Generic Core Scales were administered to children with cancer and their parents at Hacettepe University. Internal consistency was determined by using Cronbach's alpha and test-retest reliability was determined by using the intraclass correlation coefficient (ICC). Construct validity was assessed by comparing the results of the PedsQL 3.0 Cancer Module with those of the PedsQL 4.0 Generic Core Scales. Cronbach's alpha of the PedsQL 3.0 Cancer Module varied from 0.803 to 0.873 and that of the PedsQL 4.0 Generic Core Scales from 0.665 to 0.841. Test-retest ICC values of the PedsQL 3.0 Cancer Module varied from 0.877 to 0.949 and those of the PedsQL 4.0 Generic Core Scales from 0.681 to 0.824. The correlation of the PedsQL 3.0 Cancer Module with subscale scores of the PedsQL 4.0 Generic Core Scales showed that there were excellent to fair correlations between the two scales. The relationship between parent proxy-report and child self-report of the PedsQL 3.0 Cancer Module had very good correlation (r=0.694, p<0.001), as did the PedsQL 4.0 Generic Core Scales (r=0.540, p=0.002). This study demonstrated the reliability, validity, and feasibility of the Turkish version of the PedsQL 3.0 Cancer Module in 2- to 4-year-old and 5- to 7-year-old and the PedsQL 4.0 Generic Core Scales in 5- to 7-year-old in childhood cancer.

  17. Development of the Oxford Participation and Activities Questionnaire: constructing an item pool

    PubMed Central

    Kelly, Laura; Jenkinson, Crispin; Dummett, Sarah; Dawson, Jill; Fitzpatrick, Ray; Morley, David

    2015-01-01

    Purpose The Oxford Participation and Activities Questionnaire is a patient-reported outcome measure in development that is grounded on the World Health Organization International Classification of Functioning, Disability, and Health (ICF). The study reported here aimed to inform and generate an item pool for the new measure, which is specifically designed for the assessment of participation and activity in patients experiencing a range of health conditions. Methods Items were informed through in-depth interviews conducted with 37 participants spanning a range of conditions. Interviews aimed to identify how their condition impacted their ability to participate in meaningful activities. Conditions included arthritis, cancer, chronic back pain, diabetes, motor neuron disease, multiple sclerosis, Parkinson’s disease, and spinal cord injury. Transcripts were analyzed using the framework method. Statements relating to ICF themes were recast as questionnaire items and shown for review to an expert panel. Cognitive debrief interviews (n=13) were used to assess items for face and content validity. Results ICF themes relevant to activities and participation in everyday life were explored, and a total of 222 items formed the initial item pool. This item pool was refined by the research team and 28 generic items were mapped onto all nine chapters of the ICF construct, detailing activity and participation. Cognitive interviewing confirmed the questionnaire instructions, items, and response options were acceptable to participants. Conclusion Using a clear conceptual basis to inform item generation, 28 items have been identified as suitable to undergo further psychometric testing. A large-scale postal survey will follow in order to refine the instrument further and to assess its psychometric properties. The final instrument is intended for use in clinical trials and interventions targeted at maintaining or improving activity and participation. PMID:26056503

  18. Development of the Oxford Participation and Activities Questionnaire: constructing an item pool.

    PubMed

    Kelly, Laura; Jenkinson, Crispin; Dummett, Sarah; Dawson, Jill; Fitzpatrick, Ray; Morley, David

    2015-01-01

    The Oxford Participation and Activities Questionnaire is a patient-reported outcome measure in development that is grounded on the World Health Organization International Classification of Functioning, Disability, and Health (ICF). The study reported here aimed to inform and generate an item pool for the new measure, which is specifically designed for the assessment of participation and activity in patients experiencing a range of health conditions. Items were informed through in-depth interviews conducted with 37 participants spanning a range of conditions. Interviews aimed to identify how their condition impacted their ability to participate in meaningful activities. Conditions included arthritis, cancer, chronic back pain, diabetes, motor neuron disease, multiple sclerosis, Parkinson's disease, and spinal cord injury. Transcripts were analyzed using the framework method. Statements relating to ICF themes were recast as questionnaire items and shown for review to an expert panel. Cognitive debrief interviews (n=13) were used to assess items for face and content validity. ICF themes relevant to activities and participation in everyday life were explored, and a total of 222 items formed the initial item pool. This item pool was refined by the research team and 28 generic items were mapped onto all nine chapters of the ICF construct, detailing activity and participation. Cognitive interviewing confirmed the questionnaire instructions, items, and response options were acceptable to participants. Using a clear conceptual basis to inform item generation, 28 items have been identified as suitable to undergo further psychometric testing. A large-scale postal survey will follow in order to refine the instrument further and to assess its psychometric properties. The final instrument is intended for use in clinical trials and interventions targeted at maintaining or improving activity and participation.

  19. Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Yaghmanian, Rana; Smedema, Susan Miller; Thompson, Kerry

    2017-01-01

    Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu's (2009) revised World Health Organization's International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were…

  20. Comparison between utility of the Thai Pediatric Quality of Life Inventory 4.0 Generic Core Scales and 3.0 Cerebral Palsy Module.

    PubMed

    Tantilipikorn, Pinailug; Watter, Pauline; Prasertsukdee, Saipin

    2013-03-01

    Health-related quality of life (HRQOL) is increasingly being considered in the management of patients with various conditions. HRQOL instruments can be broadly classified as generic or disease-specific measures. Several generic HRQOL instruments in different languages have been developed for paediatric populations including the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) Generic Core Scale. This tool and a condition-specific tool, PedsQL 3.0 Cerebral Palsy (CP) Module, are widely used in children with CP. No psychometric properties have been reported for Thai PedsQL 4.0. Therefore, this study aimed to explore the psychometric properties of the Thai version of the PedsQL 4.0 Generic Core Scales and compare these with the values for the Thai PedsQL 3.0 CP Module reported previously. Thai PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 CP Module were completed, respectively, by children with CP and their parents or caregivers twice within 2-4 weeks. Respondents were 97 parents or caregivers and 54 children. Minimal missing data were found in most scales. Acceptable internal consistency was supported, except for Emotional, Social, and School Functioning. Intraclass correlation coefficients for parent-proxy report and self-report were good to excellent (0.625-0.849). The feasibility and reliability of the Thai PedsQL 4.0 Generic Core Scales were supported. The Thai PedsQL 3.0 CP Module showed higher values for the psychometric properties. Low-to-good correlations were found among the scales between the PedsQL 4.0 Generic Core Scales and the 3.0 CP Module. Both instruments could be used to measure HRQOL for children with CP, and may provide different information.

  1. Reliability and Validity of the Turkish Version of the PedsQL 3.0 Cancer Module for 2- to 7-Year-Old and the PedsQL 4.0 Generic Core Scales for 5- to 7-Year-Old: The Hacettepe University Experience

    PubMed Central

    Yıldız Kabak, Vesile; Yakut, Yavuz; Çetin, Mualla; Düger, Tülin

    2016-01-01

    Objective: The aim of this study was to investigate the reliability and validity of the Turkish version of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module for 2- to 7-year-old and the PedsQL 4.0 Generic Core Scales for 5- to 7-year-old in childhood cancer. Materials and Methods: The PedsQL 3.0 Cancer Module and PedsQL 4.0 Generic Core Scales were administered to children with cancer and their parents at Hacettepe University. Internal consistency was determined by using Cronbach’s alpha and test-retest reliability was determined by using the intraclass correlation coefficient (ICC). Construct validity was assessed by comparing the results of the PedsQL 3.0 Cancer Module with those of the PedsQL 4.0 Generic Core Scales. Results: Cronbach’s alpha of the PedsQL 3.0 Cancer Module varied from 0.803 to 0.873 and that of the PedsQL 4.0 Generic Core Scales from 0.665 to 0.841. Test-retest ICC values of the PedsQL 3.0 Cancer Module varied from 0.877 to 0.949 and those of the PedsQL 4.0 Generic Core Scales from 0.681 to 0.824. The correlation of the PedsQL 3.0 Cancer Module with subscale scores of the PedsQL 4.0 Generic Core Scales showed that there were excellent to fair correlations between the two scales. The relationship between parent proxy-report and child self-report of the PedsQL 3.0 Cancer Module had very good correlation (r=0.694, p<0.001), as did the PedsQL 4.0 Generic Core Scales (r=0.540, p=0.002). Conclusion: This study demonstrated the reliability, validity, and feasibility of the Turkish version of the PedsQL 3.0 Cancer Module in 2- to 4-year-old and 5- to 7-year-old and the PedsQL 4.0 Generic Core Scales in 5- to 7-year-old in childhood cancer. PMID:27095607

  2. Parents' Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life.

    PubMed

    Illum, Niels Ove; Gradel, Kim Oren

    2017-01-01

    To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken. The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were -1.10 (range: -5.31 to 5.25) and -1.11 (range: -5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions, and, finally, codes for more complex functions. Parents can assess their own children in a valid and reliable way, and if the WHO ICF-CY second-level code data set is functioning in a clinically sound way, it can be employed as a tool for identifying the severity of disabilities and for monitoring changes in those disabilities over time. The ICF-CY codes selected in this study might be one cornerstone in forming a national or even international generic set of ICF-CY codes for the benefit of children with disabilities, their parents, and caregivers and for the whole community supporting with children with disabilities on a daily and perpetual basis.

  3. Parents’ Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life

    PubMed Central

    Illum, Niels Ove; Gradel, Kim Oren

    2017-01-01

    AIM To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. METHOD Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken. RESULTS The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were −1.10 (range: −5.31 to 5.25) and −1.11 (range: −5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions, and, finally, codes for more complex functions. CONCLUSIONS Parents can assess their own children in a valid and reliable way, and if the WHO ICF-CY second-level code data set is functioning in a clinically sound way, it can be employed as a tool for identifying the severity of disabilities and for monitoring changes in those disabilities over time. The ICF-CY codes selected in this study might be one cornerstone in forming a national or even international generic set of ICF-CY codes for the benefit of children with disabilities, their parents, and caregivers and for the whole community supporting with children with disabilities on a daily and perpetual basis. PMID:28680270

  4. Longitudinal factorial invariance of the PedsQL 4.0 Generic Core Scales child self-report Version: one year prospective evidence from the California State Children's Health Insurance Program (SCHIP).

    PubMed

    Varni, James W; Limbers, Christine A; Newman, Daniel A; Seid, Michael

    2008-11-01

    The measurement of health-related quality of life (HRQOL) in pediatric medicine and health services research has grown significantly over the past decade. The paradigm shift toward patient-reported outcomes (PROs) has provided the opportunity to emphasize the value and critical need for pediatric patient self-report. In order for changes in HRQOL/PRO outcomes to be meaningful over time, it is essential to demonstrate longitudinal factorial invariance. This study examined the longitudinal factor structure of the PedsQL 4.0 Generic Core Scales over a one-year period for child self-report ages 5-17 in 2,887 children from a statewide evaluation of the California State Children's Health Insurance Program (SCHIP) utilizing a structural equation modeling framework. Specifying four- and five-factor measurement models, longitudinal structural equation modeling was used to compare factor structures over a one-year interval on the PedsQL 4.0 Generic Core Scales. While the four-factor conceptually-derived measurement model for the PedsQL 4.0 Generic Core Scales produced an acceptable fit, the five-factor empirically-derived measurement model from the initial field test of the PedsQL 4.0 Generic Core Scales produced a marginally superior fit in comparison to the four-factor model. For the five-factor measurement model, the best fitting model, strict factorial invariance of the PedsQL 4.0 Generic Core Scales across the two measurement occasions was supported by the stability of the comparative fit index between the unconstrained and constrained models, and several additional indices of practical fit including the root mean squared error of approximation, the non-normed fit index, and the parsimony normed fit index. The findings support an equivalent factor structure on the PedsQL 4.0 Generic Core Scales over time. Based on these data, it can be concluded that over a one-year period children in our study interpreted items on the PedsQL 4.0 Generic Core Scales in a similar manner.

  5. The PedsQL in pediatric cancer: reliability and validity of the Pediatric Quality of Life Inventory Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module.

    PubMed

    Varni, James W; Burwinkle, Tasha M; Katz, Ernest R; Meeske, Kathy; Dickinson, Paige

    2002-04-01

    The Pediatric Quality of Life Inventory (PedsQL) is a modular instrument designed to measure health-related quality of life (HRQOL) in children and adolescents ages 2-18 years. The PedsQL 4.0 Generic Core Scales are multidimensional child self-report and parent proxy-report scales developed as the generic core measure to be integrated with the PedsQL disease specific modules. The PedsQL Multidimensional Fatigue Scale was designed to measure fatigue in pediatric patients. The PedsQL 3.0 Cancer Module was designed to measure pediatric cancer specific HRQOL. The PedsQL Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module were administered to 339 families (220 child self-reports; 337 parent proxy-reports). Internal consistency reliability for the PedsQL Generic Core Total Scale Score (alpha = 0.88 child, 0.93 parent report), Multidimensional Fatigue Total Scale Score (alpha = 0.89 child, 0.92 parent report) and most Cancer Module Scales (average alpha = 0.72 child, 0.87 parent report) demonstrated reliability acceptable for group comparisons. Validity was demonstrated using the known-groups method. The PedsQL distinguished between healthy children and children with cancer as a group, and among children on-treatment versus off-treatment. The validity of the PedsQL Multidimensional Fatigue Scale was further demonstrated through hypothesized intercorrelations with dimensions of generic and cancer specific HRQOL. The results demonstrate the reliability and validity of the PedsQL Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module in pediatric cancer. The PedsQL may be utilized as an outcome measure in clinical trials, research, and clinical practice. Copyright 2002 American Cancer Society.

  6. Multiprofessional evaluation in clinical practice: establishing a core set of outcome measures for children with cerebral palsy.

    PubMed

    Mäenpää, Helena; Autti-Rämö, Ilona; Varho, Tarja; Forsten, Wivi; Haataja, Leena

    2017-03-01

    To develop a national consensus on outcome measures that define functional ability in children with cerebral palsy (CP) according to the International Classification of Functioning, Disability and Health (ICF) framework. The project started in 2008 in neuropaediatric units of two university hospitals and one outpatient clinic. Each professional group selected representatives to be knowledge brokers for their own specialty. Based on the evidence, expert opinion, and the ICF framework, multiprofessional teams selected the most valid measures used in clinical practice (2009-2010). Data from 269 children with CP were analysed, classified by the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System, and evaluated. The process aimed at improving and unifying clinical practice in Finland through a national consensus on the core set of measures. The selected measures were presented by professional groups, and consensus was reached on the recommended core set of measures to be used in all hospitals treating children with CP in Finland. A national consensus on relevant and feasible measures is essential for identifying differences in the effectiveness of local practices, and for conducting multisite intervention studies. This project showed that multiprofessional rehabilitation practices can be improved through respect for and inclusion of everyone involved. © 2016 Mac Keith Press.

  7. Psychometric properties of the Chinese version of the Pediatric Quality Of Life Inventory 4.0 Generic Core scales among pediatric cancer patients.

    PubMed

    Yeung, Nelson C Y; Lau, Joseph T F; Yu, Xiao-nan; Chu, Yvonne; Shing, Matthew M K; Leung, Ting Fan; Li, Chi Kong; Fok, Tai Fai; Mak, Winnie W S

    2013-01-01

    The Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales are commonly used to assess health-related quality of life of healthy children and pediatric patients. Validation of the Generic Core Scales among Chinese pediatric cancer patients has not been reported in the literature. The scales can serve to measure different quality-of-life domains that are not captured by the PedsQL Cancer Module. Psychometric properties of the Chinese version of the PedsQL 4.0 among pediatric cancer patients and their caretakers were examined. The Generic Core Scales were administered to 335 pairs of pediatric cancer patients (aged 8-18 years) and their caretakers in Hong Kong. A 5-factor structure (physical, emotional, social, school-related cognitive function, and missed school) was identified in the patient and proxy versions of the scales using confirmatory factor analysis. Both versions of the total scale reported Cronbach α's of .90 or greater, with almost all subscales reporting α's of .70 or greater. Test-retest reliability at 2 weeks was acceptable (intraclass correlations ≥0.60) for a majority of subscales. Agreement between patients' and caretakers' ratings was medium. The scales demonstrated acceptable psychometric properties and construct validity. This study validated the Chinese version of the Generic Core Scales among pediatric cancer patients and their caretakers, which supports the future use of the scales in clinical settings. The Generic Core Scales can also be supplementary to the PedsQL Cancer Module for measuring multiple domains of quality of life in cancer population.

  8. Cortical inhibitory and excitatory function in drug-naive generalized anxiety disorder.

    PubMed

    Li, Cheng-Ta; Lu, Chia-Feng; Lin, Hui-Ching; Huang, Ying-Zu; Juan, Chi-Hung; Su, Tung-Ping; Bai, Ya-Mei; Chen, Mu-Hong; Lin, Wei-Chen

    A growing body of evidence suggests that deficits in GABAergic inhibitory and glutamatergic excitatory neurotransmission may be involved in the core pathophysiology of generalized anxiety disorder (GAD), a disease characterized by pathological anxious worrying. The aim of the present study was to measure motor cortical excitability by paired-pulse transcranial magnetic stimulation (ppTMS) in patients with GAD. ppTMS measurements of excitation and inhibition from bilateral motor cortices were investigated in 26 right-handed GAD patients who were drug-naïve (half of them with a comorbidity of major depressive disorder) and 35 right-handed age- and sex-matched healthy controls. Short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), and long-interval intracortical inhibition (LICI) were studied; evidence indicated that these are mainly mediated by GABA-A receptors, glutamate receptors, and GABA-B receptors, respectively. After correcting for multiple comparisons, GAD patients had significantly lower left ICF (p < 0.001, Cohen's d = 1.348) and right ICF (p = 0.001, Cohen's d = 0.963), but not SICI and LICI, than did healthy controls. No significant difference of the ICF values was found between GAD with and without depressive disorders. Multivariate linear regression analysis revealed that left ICF (B = -4.990, 95% CI = -8.821 to -1.039, p = 0.007) and group (B = 13.179, 95% CI = 10.208 to 16.149, p = 0.001) predicted anxiety symptoms significantly. The present study provided direct evidence to support that generalized anxiety disorder is characterized by impaired intra-cortical facilitation of motor cortex, suggesting glutamate-related excitatory dysfunction may play a key role in pathological anxiety. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. What Do Clinicians Consider when Assessing Chronic Low Back Pain? A Content Analysis of Multidisciplinary Pain Centre Team Assessments of Functioning, Disability, and Health.

    PubMed

    Bagraith, Karl S; Strong, Jenny; Meredith, Pamela J; McPhail, Steven M

    2018-05-22

    Beyond expert suggestions as to the appropriate subject matter for chronic pain assessments, little is known about the actual content of multidisciplinary pain centre (MPC) clinical assessments. The International Classification of Functioning, Disability and Health Low Back Pain Core Set (ICF LBP-CS) provides a universal language to support the consistent description of LBP-related assessments across disciplines within multidisciplinary teams (MDT). This study sought to map the content of MPC clinical assessments to the ICF to: 1) identify and compare the content of clinical MDT assessments using a cross-disciplinary framework and, 2) examine the content validity of the LBP-CS. A qualitative examination of MPC team clinical assessments of CLBP was undertaken. MDT (pain medicine, psychiatry, nursing, physiotherapy, occupational therapy, and psychology) assessments were audio-recorded and transcribed. Concepts were extracted from transcripts using a meaning condensation procedure and then linked to the ICF. Across seven MDT assessments, comprised of 42 discipline-specific assessments and 241,209 transcribed words, 8596 concepts were extracted. Contextual factors (i.e., the person and environment), except for physiotherapy, accounted for almost half of each discipline's assessments (range: 49% - 58%) Concepts spanned 113 second-level ICF categories, including 73/78 LBP-CS categories. Overall, the findings revealed novel insights into the content of MPC clinical assessments that can be used to improve healthcare delivery. ICF-based assessment profiles demonstrated unique contributions from each discipline to CLBP assessment. Finally, users of the LBP-CS can be confident that the tool exhibits sound content validity from the perceptive of MDT assessments of functioning, disability, and health.

  10. Feasibility, reliability, and validity of the Pediatric Quality of Life Inventory ™ generic core scales, cancer module, and multidimensional fatigue scale in long-term adult survivors of pediatric cancer.

    PubMed

    Robert, Rhonda S; Paxton, Raheem J; Palla, Shana L; Yang, Grace; Askins, Martha A; Joy, Shaini E; Ater, Joann L

    2012-10-01

    Most health-related quality of life assessments are designed for either children or adults and have not been evaluated for adolescent and young adult survivors of pediatric cancer. The objective of this study was to examine the feasibility, reliability, and validity of the Pediatric Quality of Life Inventory (PedsQL ™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale in adult survivors of pediatric cancer. Adult survivors (n = 64; Mean age 35 year old; >2 years after treatment) completed the PedsQL™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale. Feasibility was examined with floor and ceiling effects; and internal consistency was determined by Cronbach's coefficient alpha calculations. Inter-factor correlations were also assessed. Significant ceiling effects were observed for the scales of social function, nausea, procedural anxiety, treatment anxiety, and communication. Internal consistency for all subscales was within the recommended ranges (α ≥ 0.70). Moderate to strong correlations between most Cancer Module and Generic Core Scales (r = 0.25 to r = 0.76) and between the Multidimensional Fatigue Scale and Generic Core Scales (r = 0.37 to r = 0.73). The PedsQL™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale appear to be feasible for an older population of pediatric cancer survivors; however, some of the Cancer Module Scales (nausea, procedural/treatment anxiety, and communication) were deemed not relevant for long-term survivors. More information is needed to determine whether the issues addressed by these modules are meaningful to long-term adult survivors of pediatric cancers. Copyright © 2012 Wiley Periodicals, Inc.

  11. Development of a krypton-doped gas symmetry capsule platform for x-ray spectroscopy of implosion cores on the NIF

    DOE PAGES

    Ma, T.; Chen, H.; Patel, P. K.; ...

    2016-08-18

    The electron temperature at stagnation of an ICF implosion can be measured from the emission spectrum of high-energy x-rays that pass through the cold material surrounding the hot stagnating core. We describe a platform developed on the National Ignition Facility where trace levels of a mid-Z dopant (krypton) are added to the fuel gas of a symcap (symmetry surrogate) implosion to allow for the use of x-ray spectroscopy of the krypton line emission.Published by AIP Publishing

  12. Development of a krypton-doped gas symmetry capsule platform for x-ray spectroscopy of implosion cores on the NIF.

    PubMed

    Ma, T; Chen, H; Patel, P K; Schneider, M B; Barrios, M A; Casey, D T; Chung, H-K; Hammel, B A; Berzak Hopkins, L F; Jarrott, L C; Khan, S F; Lahmann, B; Nora, R; Rosenberg, M J; Pak, A; Regan, S P; Scott, H A; Sio, H; Spears, B K; Weber, C R

    2016-11-01

    The electron temperature at stagnation of an ICF implosion can be measured from the emission spectrum of high-energy x-rays that pass through the cold material surrounding the hot stagnating core. Here we describe a platform developed on the National Ignition Facility where trace levels of a mid-Z dopant (krypton) are added to the fuel gas of a symcap (symmetry surrogate) implosion to allow for the use of x-ray spectroscopy of the krypton line emission.

  13. Development of a krypton-doped gas symmetry capsule platform for x-ray spectroscopy of implosion cores on the NIF

    NASA Astrophysics Data System (ADS)

    Ma, T.; Chen, H.; Patel, P. K.; Schneider, M. B.; Barrios, M. A.; Casey, D. T.; Chung, H.-K.; Hammel, B. A.; Berzak Hopkins, L. F.; Jarrott, L. C.; Khan, S. F.; Lahmann, B.; Nora, R.; Rosenberg, M. J.; Pak, A.; Regan, S. P.; Scott, H. A.; Sio, H.; Spears, B. K.; Weber, C. R.

    2016-11-01

    The electron temperature at stagnation of an ICF implosion can be measured from the emission spectrum of high-energy x-rays that pass through the cold material surrounding the hot stagnating core. Here we describe a platform developed on the National Ignition Facility where trace levels of a mid-Z dopant (krypton) are added to the fuel gas of a symcap (symmetry surrogate) implosion to allow for the use of x-ray spectroscopy of the krypton line emission.

  14. Space Generic Open Avionics Architecture (SGOAA) standard specification

    NASA Technical Reports Server (NTRS)

    Wray, Richard B.; Stovall, John R.

    1994-01-01

    This standard establishes the Space Generic Open Avionics Architecture (SGOAA). The SGOAA includes a generic functional model, processing structural model, and an architecture interface model. This standard defines the requirements for applying these models to the development of spacecraft core avionics systems. The purpose of this standard is to provide an umbrella set of requirements for applying the generic architecture models to the design of a specific avionics hardware/software processing system. This standard defines a generic set of system interface points to facilitate identification of critical services and interfaces. It establishes the requirement for applying appropriate low level detailed implementation standards to those interfaces points. The generic core avionics functions and processing structural models provided herein are robustly tailorable to specific system applications and provide a platform upon which the interface model is to be applied.

  15. Comparison of the ICF Core Set for Cardiopulmonary Conditions in the Acute Hospital Setting among Different Types of Transplant Patients

    ERIC Educational Resources Information Center

    Ding, Xinhua

    2010-01-01

    To compare the functioning profiles of patients receiving different types of organ transplants using the International Classification of Functioning, Disability, and Health. The patients (n=102) were enrolled between days 5 and 10 after discharge following receipt of an organ transplant, and assessed for sociodemographic variables, the Functional…

  16. The ICF Core Sets for hearing loss--researcher perspective. Part I: Systematic review of outcome measures identified in audiological research.

    PubMed

    Granberg, Sarah; Dahlström, Jennie; Möller, Claes; Kähäri, Kim; Danermark, Berth

    2014-02-01

    To review the literature in order to identify outcome measures used in research on adults with hearing loss (HL) as part of the ICF Core Sets development project, and to describe study and population characteristics of the reviewed studies. A systematic review methodology was applied using multiple databases. A comprehensive search was conducted and two search pools were created, pool I and pool II. The study population included adults (≥ 18 years of age) with HL and oral language as the primary mode of communication. 122 studies were included. Outcome measures were distinguished by 'instrument type', and 10 types were identified. In total, 246 (pool I) and 122 (pool II) different measures were identified, and only approximately 20% were extracted twice or more. Most measures were related to speech recognition. Fifty-one different questionnaires were identified. Many studies used small sample sizes, and the sex of participants was not revealed in several studies. The low prevalence of identified measures reflects a lack of consensus regarding the optimal outcome measures to use in audiology. Reflections and discussions are made in relation to small sample sizes and the lack of sex differentiation/descriptions within the included articles.

  17. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hansen, Stephanie B.; Harding, Eric C.; Knapp, Patrick F.

    The burning core of an inertial confinement fusion (ICF) plasma produces bright x-rays at stagnation that can directly diagnose core conditions essential for comparison to simulations and understanding fusion yields. These x-rays also backlight the surrounding shell of warm, dense matter, whose properties are critical to understanding the efficacy of the inertial confinement and global morphology. In this work, we show that the absorption and fluorescence spectra of mid-Z impurities or dopants in the warm dense shell can reveal the optical depth, temperature, and density of the shell and help constrain models of warm, dense matter. This is illustrated bymore » the example of a high-resolution spectrum collected from an ICF plasma with a beryllium shell containing native iron impurities. Lastly, analysis of the iron K-edge provides model-independent diagnostics of the shell density (2.3 × 10 24 e/cm 3) and temperature (10 eV), while a 12-eV red shift in Kβ and 5-eV blue shift in the K-edge discriminate among models of warm dense matter: Both shifts are well described by a self-consistent field model based on density functional theory but are not fully consistent with isolated-atom models using ad-hoc density effects.« less

  18. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Caillaud, T.; Landoas, O.; Briat, M.

    Inertial confinement fusion (ICF) requires a high resolution ({approx}10 {mu}m) neutron imaging system to observe deuterium and tritium (DT) core implosion asymmetries. A new large (150 mm entrance diameter: scaled for Laser MegaJoule [P. A. Holstein, F. Chaland, C. Charpin, J. M. Dufour, H. Dumont, J. Giorla, L. Hallo, S. Laffite, G. Malinie, Y. Saillard, G. Schurtz, M. Vandenboomgaerde, and F. Wagon, Laser and Particle Beams 17, 403 (1999)]) neutron imaging detector has been developed for such ICF experiments. The detector has been fully characterized using a linear accelerator and a {sup 60}Co {gamma}-ray source. A penumbral aperture was usedmore » to observe DT-gas-filled target implosions performed on the OMEGA laser facility. [T. R. Boehly, D. L. Brown, R. S. Craxton, R. L. Keck, J. P. Knauer, J. H. Kelly, T. J. Kessler, S. A. Kumpan, S. J. Loucks, S. A. Letzring, F. J. Marshall, R. L. McCrory, S. F. B. Morse, W. Seka, J. M. Soures, and C. P. Verdon, Opt. Commun. 133, 495 (1997)] Neutron core images of 14 MeV with a resolution of 15 {mu}m were obtained and are compared to x-ray images of comparable resolution.« less

  19. Validation of Persian Version of PedsQL™ 4.0™ Generic Core Scales in Toddlers and Children

    PubMed Central

    Gheissari, Alaleh; Farajzadegan, Ziba; Heidary, Maryam; Salehi, Fatemeh; Masaeli, Ali; Mazrooei, Amin; Varni, James W; Fallah, Zahra; Zandieh, Fariborz

    2012-01-01

    Introduction: To evaluate the reliability, validity and feasibility of the Persian version of the Pediatric Quality of Life inventory (PedsQL™ 4.0™ 4.0) Generic Core Scales in Iranian healthy students ages 7-15 and chronically ill children ages 2-18. Methods: We followed the translation methodology proposed by developer to validate Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales for children. Six hundred and sixty children and adolescents and their parents were enrolled. Sample of 160 healthy students were chosen by random cluster method between 4 regions of Isfahan education offices and 60 chronically ill children were recruited from St. Alzahra hospital private clinics. The questionnaires were fulfilled by the participants. Results: The Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales discriminated between healthy and chronically ill children (healthy students mean score was 12.3 better than chronically ill children, P<0.001). Cronbachs’ alpha internal consistency values exceeded 0.7 for children self reports and proxy reports of children 5-7 years old and 13-18 years old. Reliability of proxy reports for 2-4 years old was much lower than 0.7. Although, proxy reports for chronically ill children 8-12 years old was more than 0.7, these reports for healthy children with same age group was slightly lower than 0.7. Constructive, criterion face and content validity were acceptable. In addition, the Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales was feasible and easy to complete. Conclusion: Results showed that Persian version of PedsQL™ 4.0™ 4.0 Generic Core Scales is valid and acceptable for pediatric health researches. It is necessary to alternate scoring for 2-4 years old questionnaire and to find a way to increase reliability for healthy children aged 8-12 years especially, according to Iranian culture. PMID:22701775

  20. Functioning and Disability Profile of Children with Microcephaly Associated with Congenital Zika Virus Infection.

    PubMed

    Ferreira, Haryelle Náryma Confessor; Schiariti, Veronica; Regalado, Isabelly Cristina Rodrigues; Sousa, Klayton Galante; Pereira, Silvana Alves; Fechine, Carla Patrícia Novaes Dos Santos; Longo, Egmar

    2018-05-29

    The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference, and other clinical data were collected from medical charts, physical examinations, measuring instruments, and interviews with the children and their parents. The Brazilian Portuguese version of the Brief Common ICF Core Set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no problem, mild problem, moderate problem, severe problem, complete problem). For environmental factors, 0 represents no barrier and 4 represents complete barrier; +0, no facilitator and +4, complete facilitator. A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Paraíba states, Brazil. The average age of the participants was 21 months, monthly income was ≈USD 300.00, and head circumference z-scores ranged between 0.92 and -5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a complete facilitator for the immediate family, friends, and health services, systems, and policies, as well as a complete barrier to societal attitudes. This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce the need to maximize health care and access to information, based on the ICF, for multiprofessional teams, administrators, family members, and children.

  1. Can we decide which outcomes should be measured in every clinical trial? A scoping review of the existing conceptual frameworks and processes to develop core outcome sets.

    PubMed

    Idzerda, Leanne; Rader, Tamara; Tugwell, Peter; Boers, Maarten

    2014-05-01

    The usefulness of randomized control trials to advance clinical care depends upon the outcomes reported, but disagreement on the choice of outcome measures has resulted in inconsistency and the potential for reporting bias. One solution to this problem is the development of a core outcome set: a minimum set of outcome measures deemed critical for clinical decision making. Within rheumatology the Outcome Measures in Rheumatology (OMERACT) initiative has pioneered the development of core outcome sets since 1992. As the number of diseases addressed by OMERACT has increased and its experience in formulating core sets has grown, clarification and update of the conceptual framework and formulation of a more explicit process of area/domain core set development has become necessary. As part of the update process of the OMERACT Filter criteria to version 2, a literature review was undertaken to compare and contrast the OMERACT conceptual framework with others within and outside rheumatology. A scoping search was undertaken to examine the extent, range, and nature of conceptual frameworks for core set outcome selection in health. We searched the following resources: Cochrane Library Methods Group Register; Medline; Embase; PsycInfo; Environmental Studies and Policy Collection; and ABI/INFORM Global. We also conducted a targeted Google search. Five conceptual frameworks were identified: the WHO tripartite definition of health; the 5 Ds (discomfort, disability, drug toxicity, dollar cost, and death); the International Classification of Functioning (ICF); PROMIS (Patient-Reported Outcomes Measurement System); and the Outcomes Hierarchy. Of these, only the 5 Ds and ICF frameworks have been systematically applied in core set development. Outside the area of rheumatology, several core sets were identified; these had been developed through a limited range of consensus-based methods with varying degrees of methodological rigor. None applied a framework to ensure content validity of the end product. This scoping review reinforced the need for clear methods and standards for core set development. Based on these findings, OMERACT will make its own conceptual framework and working process more explicit. Proposals for how to achieve this were discussed at the OMERACT 11 conference.

  2. Eligibility, the ICF and the UN Convention: Australian perspectives

    PubMed Central

    2011-01-01

    The UN Convention on the Rights of Persons with Disabilities, in Australia, acts as a philosophical and moral statement and framework guiding integrated and strategic policy across the nation. Broad policy agreement has been reached by governments, and both the government and non-government sectors are developing strategies for implementation or evaluation. There is however a need for a more integrated approach to disability policy and information, reflecting all three components of the Italian project: • legislation and a high level philosophical framework and policy guide; • a technical framework that can underpin specific policies and programs aiming to achieve the major goals; and , • a language and set of tools, relating to both the above, that provide infrastructure for assessment methods and information systems. The International Classification of Functioning, Disability and Health (ICF) is the ideal tool to support the latter two components, consistent with the UN Convention. While the ICF has been used as the basis for national data standards, in population surveys and in the national data collection on disability support services, there is considerable scope for greater use of it, including using all domains of the Activities and Participation and the Environmental Factors component for policy, information and service provision, to advance a disability-inclusive society. Information available from the income support system and from generic services could be enhanced by reference to the ICF components. It would be of significant national value in Australia, especially as a ‘continuum of care’ is desired, if consistency of concepts and information were expanded across health and social welfare sectors. It would then be possible to obtain consistent data from health, aged care, disability and community services systems about key aspects of health and functioning, building a consolidated picture of access and experience across these sectors. Without attention to all three components of the Italian project and continuing effort to meet the challenges identified in this paper, it will not be possible to determine whether the goals of Australia’s National Disability Agreement or the ambitions of the Convention are achieved. PMID:21624192

  3. Which outcomes are most important to people with aphasia and their families? an international nominal group technique study framed within the ICF.

    PubMed

    Wallace, Sarah J; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine; Cruice, Madeline; Isaksen, Jytte; Kong, Anthony Pak Hin; Simmons-Mackie, Nina; Scarinci, Nerina; Gauvreau, Christine Alary

    2017-07-01

    To identify important treatment outcomes from the perspective of people with aphasia and their families using the ICF as a frame of reference. The nominal group technique was used with people with aphasia and their family members in seven countries to identify and rank important treatment outcomes from aphasia rehabilitation. People with aphasia identified outcomes for themselves; and family members identified outcomes for themselves and for the person with aphasia. Outcomes were analysed using qualitative content analysis and ICF linking. A total of 39 people with aphasia and 29 family members participated in one of 16 nominal groups. Inductive qualitative content analysis revealed the following six themes: (1) Improved communication; (2) Increased life participation; (3) Changed attitudes through increased awareness and education about aphasia; (4) Recovered normality; (5) Improved physical and emotional well-being; and (6) Improved health (and support) services. Prioritized outcomes for both participant groups linked to all ICF components; primary activity/participation (39%) and body functions (36%) for people with aphasia, and activity/participation (49%) and environmental factors (28%) for family members. Outcomes prioritized by family members relating to the person with aphasia, primarily linked to body functions (60%). People with aphasia and their families identified treatment outcomes which span all components of the ICF. This has implications for research outcome measurement and clinical service provision which currently focuses on the measurement of body function outcomes. The wide range of desired outcomes generated by both people with aphasia and their family members, highlights the importance of collaborative goal setting within a family-centred approach to rehabilitation. These results will be combined with other stakeholder perspectives to establish a core outcome set for aphasia treatment research. Implications for Rehabilitation Important outcomes for people with aphasia and their families span all components of the ICF. The relevancy and translation of research findings may be increased by measuring and reporting research outcomes which are important to people living with aphasia. The results of this study indicate that important treatment outcomes for people living with aphasia most frequently link to the activity/participation and body function components of the ICF. The outcomes identified in this study suggest a broad role for clinicians working in aphasia rehabilitation. The categories of identified outcomes may be used clinically as a starting point in goal-setting discussions with clients and their families.

  4. Heterogeneous clinical presentation in ICF syndrome: correlation with underlying gene defects

    PubMed Central

    Weemaes, Corry MR; van Tol, Maarten JD; Wang, Jun; van Ostaijen-ten Dam, Monique M; van Eggermond, Marja CJA; Thijssen, Peter E; Aytekin, Caner; Brunetti-Pierri, Nicola; van der Burg, Mirjam; Graham Davies, E; Ferster, Alina; Furthner, Dieter; Gimelli, Giorgio; Gennery, Andy; Kloeckener-Gruissem, Barbara; Meyn, Stephan; Powell, Cynthia; Reisli, Ismail; Schuetz, Catharina; Schulz, Ansgar; Shugar, Andrea; van den Elsen, Peter J; van der Maarel, Silvère M

    2013-01-01

    Immunodeficiency with centromeric instability and facial anomalies (ICF) syndrome is a primary immunodeficiency, predominantly characterized by agammaglobulinemia or hypoimmunoglobulinemia, centromere instability and facial anomalies. Mutations in two genes have been discovered to cause ICF syndrome: DNMT3B and ZBTB24. To characterize the clinical features of this syndrome, as well as genotype–phenotype correlations, we compared clinical and genetic data of 44 ICF patients. Of them, 23 had mutations in DNMT3B (ICF1), 13 patients had mutations in ZBTB24 (ICF2), whereas for 8 patients, the gene defect has not yet been identified (ICFX). While at first sight these patients share the same immunological, morphological and epigenetic hallmarks of the disease, systematic evaluation of all reported informative cases shows that: (1) the humoral immunodeficiency is generally more pronounced in ICF1 patients, (2) B- and T-cell compartments are both involved in ICF1 and ICF2, (3) ICF2 patients have a significantly higher incidence of intellectual disability and (4) congenital malformations can be observed in some ICF1 and ICF2 cases. It is expected that these observations on prevalence and clinical presentation will facilitate mutation-screening strategies and help in diagnostic counseling. PMID:23486536

  5. GERICOS: A Generic Framework for the Development of On-Board Software

    NASA Astrophysics Data System (ADS)

    Plasson, P.; Cuomo, C.; Gabriel, G.; Gauthier, N.; Gueguen, L.; Malac-Allain, L.

    2016-08-01

    This paper presents an overview of the GERICOS framework (GEneRIC Onboard Software), its architecture, its various layers and its future evolutions. The GERICOS framework, developed and qualified by LESIA, offers a set of generic, reusable and customizable software components for the rapid development of payload flight software. The GERICOS framework has a layered structure. The first layer (GERICOS::CORE) implements the concept of active objects and forms an abstraction layer over the top of real-time kernels. The second layer (GERICOS::BLOCKS) offers a set of reusable software components for building flight software based on generic solutions to recurrent functionalities. The third layer (GERICOS::DRIVERS) implements software drivers for several COTS IP cores of the LEON processor ecosystem.

  6. Psychometric properties of the self-report Malay version of the Pediatric Quality of Life (PedsQLTM) 4.0 Generic Core Scales among multiethnic Malaysian adolescents.

    PubMed

    Ainuddin, Husna A; Loh, Siew Yim; Chinna, Karuthan; Low, Wah Yun; Roslani, April Camilla

    2015-06-01

    Adolescence is the potential period for growth and optimal functioning, but developmental issues like time of transition from childhood to adulthood will create stress and affect the adolescent's quality of life (QOL). However, there is a lack of research tool for measuring adolescent's QOL in Malaysia. The aim of the study was to determine the validity and reliability of the self-report Malay version of the pediatric QOL (PedsQL™) 4.0 Generic Core Scales in assessing the QOL of Malaysian adolescents. A cross-sectional study design using the 23-item self-report Malay version of the PedsQL 4.0 Generic Core Scales was administered on a convenient cluster sampling (n = 297 adolescent) from a secondary school. The internal consistency reliability had Cronbach's α values ranging from .70 to .89. Factor analysis reported a six-factor structure via principal axis factor analysis. In conclusion, the self-report Malay version of the pediatric QOL 4.0 Generic Core Scales is a reliable and valid tool to measure the QOL of multiethnic Malaysian adolescents. © The Author(s) 2013.

  7. Measuring health-related quality of life in Hungarian children with heart disease: psychometric properties of the Hungarian version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales and the Cardiac Module.

    PubMed

    Berkes, Andrea; Pataki, István; Kiss, Mariann; Kemény, Csilla; Kardos, László; Varni, James W; Mogyorósy, Gábor

    2010-01-28

    The aim of the study was to investigate the psychometric properties of the Hungarian version of the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales and Cardiac Module. The PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Cardiac Module was administered to 254 caregivers of children (aged 2-18 years) and to 195 children (aged 5-18 years) at a pediatric cardiology outpatient unit. A postal survey on a demographically group-matched sample of the general population with 525 caregivers of children (aged 2-18 years) and 373 children (aged 5-18 years) was conducted with the PedsQL 4.0 Generic Core Scale. Responses were described, compared over subgroups of subjects, and were used to assess practical utility, distributional coverage, construct validity, internal consistency, and inter-reporter agreement of the instrument. The moderate scale-level mean percentage of missing item responses (range 1.8-2.3%) supported the feasibility of the Generic Core Scales for general Hungarian children. Minimal to moderate ceiling effects and no floor effects were found on the Generic Core Scales. We observed stronger ceiling than floor effects in the Cardiac Module. Most of the scales showed satisfactory reliability with Cronbach's alpha estimates exceeding 0.70. Generally, moderate to good agreement was found between self- and parent proxy-reports in the patient and in the comparison group (intraclass correlation coefficient range 0.52-0.77), but remarkably low agreement in the perceived physical appearance subscale in the age group 5-7 years (0.18) and for the treatment II scale (problems on taking heart medicine) scale of the Cardiac Module in children aged 8-12 years (0.39). Assessing the construct validity of the questionnaires, statistically significant difference was found between the patient group and the comparison group only in the Physical Functioning Scale scores (p = 0.003) of the child self-report component, and in Physical (p = 0.022), Emotional, (p = 0.017), Psychosocial Summary (p = 0.019) scores and in the total HRQoL (health-related quality of life) scale score (p = 0.034) for parent proxy-report. The findings generally support the feasibility, reliability and validity of the Hungarian translation of the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Cardiac Module in Hungarian children with heart disease.

  8. A systematic literature review of the situation of the International Classification of Functioning, Disability, and Health and the International Classification of Functioning, Disability, and Health-Children and Youth version in education: a useful tool or a flight of fancy?

    PubMed

    Moretti, Marta; Alves, Ines; Maxwell, Gregor

    2012-02-01

    This article presents the outcome of a systematic literature review exploring the applicability of the International Classification of Functioning, Disability, and Health (ICF) and its Children and Youth version (ICF-CY) at various levels and in processes within the education systems in different countries. A systematic database search using selected search terms has been used. The selection of studies was then refined further using four protocols: inclusion and exclusion protocols at abstract and full text and extraction levels along with a quality protocol. Studies exploring the direct relationship between education and the ICF/ICF-CY were sought.As expected, the results show a strong presence of studies from English-speaking countries, namely from Europe and North America. The articles were mainly published in noneducational journals. The most used ICF/ICF-CY components are activity and participation, participation, and environmental factors. From the analysis of the papers included, the results show that the ICF/ICF-CY is currently used as a research tool, theoretical framework, and tool for implementing educational processes. The ICF/ICF-CY can provide a useful language to the education field where there is currently a lot of disparity in theoretical, praxis, and research issues. Although the systematic literature review does not report a high incidence of the use of the ICF/ICF-CY in education, the results show that the ICF/ICF-CY model and classification have potential to be applied in education systems.

  9. Kinetic studies of ICF implosions

    DOE PAGES

    Kagan, Grigory; Herrmann, H. W.; Kim, Y. -H.; ...

    2016-05-26

    Here, kinetic effects on inertial confinement fusion have been investigated. In particular, inter-ion-species diffusion and suprathermal ion distribution have been analyzed. The former drives separation of the fuel constituents in the hot reacting core and governs mix at the shell/fuel interface. The latter underlie measurements obtained with nuclear diagnostics, including the fusion yield and inferred ion burn temperatures. Basic mechanisms behind and practical consequences from these effects are discussed.

  10. Validation of the Korean version of the pediatric quality of life inventory 4.0 (PedsQL) generic core scales in school children and adolescents using the Rasch model.

    PubMed

    Kook, Seung Hee; Varni, James W

    2008-06-02

    The Pediatric Quality of Life Inventory (PedsQL) is a child self-report and parent proxy-report instrument designed to assess health-related quality of life (HRQOL) in healthy and ill children and adolescents. It has been translated into over 70 international languages and proposed as a valid and reliable pediatric HRQOL measure. This study aimed to assess the psychometric properties of the Korean translation of the PedsQL 4.0 Generic Core Scales. Following the guidelines for linguistic validation, the original US English scales were translated into Korean and cognitive interviews were administered. The field testing responses of 1425 school children and adolescents and 1431 parents to the Korean version of PedsQL 4.0 Generic Core Scales were analyzed utilizing confirmatory factor analysis and the Rasch model. Consistent with studies using the US English instrument and other translation studies, score distributions were skewed toward higher HRQOL in a predominantly healthy population. Confirmatory factor analysis supported a four-factor and a second order-factor model. The analysis using the Rasch model showed that person reliabilities are low, item reliabilities are high, and the majority of items fit the model's expectation. The Rasch rating scale diagnostics showed that PedsQL 4.0 Generic Core Scales in general have the optimal number of response categories, but category 4 (almost always a problem) is somewhat problematic for the healthy school sample. The agreements between child self-report and parent proxy-report were moderate. The results demonstrate the feasibility, validity, item reliability, item fit, and agreement between child self-report and parent proxy-report of the Korean version of PedsQL 4.0 Generic Core Scales for school population health research in Korea. However, the utilization of the Korean version of the PedsQL 4.0 Generic Core Scales for healthy school populations needs to consider low person reliability, ceiling effects and cultural differences, and further validation studies on Korean clinical samples are required.

  11. The application of the International Classification of Functioning, Disability, and Health in psychiatry: possible reasons for the lack of implementation.

    PubMed

    Álvarezz, Ana Sabela

    2012-02-01

    The purpose of this article was to examine the application of the International Classification of Functioning, Disability, and Health (ICF) in the field of psychiatry in the last 10 yrs since the ICF was launched. The hypothesis is that the application of the ICF in the field of psychiatry has not been yet much explored. Therefore, the objective of this article was to provide reasons to explain the difficult implementation of the ICF in this field, which in turn, might account for the lack of studies. A literature search was conducted using the terms ICF AND mental illness OR mental disorders OR psychiatry in titles, abstracts, and key words of articles collected in the databases ISI Web of Knowledge, ScienceDirect and Medline from 2001 to 2010. A total of 64 full-length articles were retrieved and reviewed, and among them, 13 were eventually included in this review because they were related to the ICF in psychiatry. Of the 13 studies identified concerning the ICF and mental disorders, 7 focus on the implementation of the ICF in the clinical practice, and 6 are theoretical papers discussing the potential benefits of the ICF for the field of psychiatry. A number of reasons can be suggested to explain the paucity of studies on the use of the ICF in psychiatry in the last 10 yrs: (1) the novelty of the ICF and the dominance of the medical model, (2) the belief that disability is just about physical conditions, (3) the influence of medication on capacity and performance, (4) the complex structure of the ICF, (5) the intrinsic limitations of the ICF, and (6) limitations in the accessibility of the ICF to some medical professionals.

  12. The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records. A Systematic Literature Review.

    PubMed

    Maritz, Roxanne; Aronsky, Dominik; Prodinger, Birgit

    2017-09-20

    The International Classification of Functioning, Disability and Health (ICF) is the World Health Organization's standard for describing health and health-related states. Examples of how the ICF has been used in Electronic Health Records (EHRs) have not been systematically summarized and described yet. To provide a systematic review of peer-reviewed literature about the ICF's use in EHRs, including related challenges and benefits. Peer-reviewed literature, published between January 2001 and July 2015 was retrieved from Medline ® , CINAHL ® , Scopus ® , and ProQuest ® Social Sciences using search terms related to ICF and EHR concepts. Publications were categorized according to three groups: Requirement specification, development and implementation. Information extraction was conducted according to a qualitative content analysis method, deductively informed by the evaluation framework for Health Information Systems: Human, Organization and Technology-fit (HOT-fit). Of 325 retrieved articles, 17 publications were included; 4 were categorized as requirement specification, 7 as development, and 6 as implementation publications. Information regarding the HOT-fit evaluation framework was summarized. Main benefits of using the ICF in EHRs were its unique comprehensive perspective on health and its interdisciplinary focus. Main challenges included the fact that the ICF is not structured as a formal terminology as well as the need for a reduced number of ICF codes for more feasible and practical use. Different approaches and technical solutions exist for integrating the ICF in EHRs, such as combining the ICF with other existing standards for EHR or selecting ICF codes with natural language processing. Though the use of the ICF in EHRs is beneficial as this review revealed, the ICF could profit from further improvements such as formalizing the knowledge representation in the ICF to support and enhance interoperability.

  13. The implementation of the ICF among Israeli rehabilitation centers--the case of physical therapy.

    PubMed

    Jacob, Tamar

    2013-10-01

    The extent of the implementation of the International Classification of Functioning, Disability and Health (ICF), developed by the WHO, in rehabilitation units and in physical therapy (PT) departments is unknown. The study aims to describe the extent to which the ICF has been implemented in PT services within rehabilitation units in Israel. To update data on ICF implementation since its inception. An online semi-structured survey was administered to 25 physiotherapists in charge of PT departments in all rehabilitation units throughout Israel. Rehabilitation units were grouped into three categories: general, geriatric and pediatric. The questionnaire included items regarding the ICF implementation, its strengths, and weaknesses. Twenty two physiotherapists (88%) completed the questionnaire. The majority was familiar with the ICF and nearly two thirds reported partial implementation in their units. Implementation focused mostly on adopting the biopsychosocial concepts and using ICF terms. The ICF was not used either for evaluating patients, or for reporting or encoding patient information. Physiotherapists, directors of most Israeli PT departments in rehabilitation units are familiar with the ICF; however, its clinical implementation is very limited. There is need for further research into the processes of knowledge transfer and implementation of the ICF, in order to better understand the factors that facilitate and those that impede ICF implementation.

  14. The PedsQL in pediatric cerebral palsy: reliability and validity of the Chinese version pediatric quality of life inventory 4.0 generic core scales and 3.0 cerebral palsy module.

    PubMed

    Yang, Xue; Xiao, Nong; Yan, Jianying

    2011-03-01

    This investigation examines the reliability, validity, and sensitivity of the Chinese version Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and 3.0 cerebral palsy (CP) Module in pediatric CP. The study sample was comprised of 126 parents of children with CP between the ages of 2 and 12 years including 18 child respondents 5-12 years of age. Mean age of the 87 boys (69.0%) and 39 girls (31.0%) was 4 years 1 month (SD 2 years 2 month). Reliability was demonstrated for the PedsQL 4.0 (α = 0.86 child, 0.89 parent) and CP Module (α = 0.91 child, 0.96 parent). The PedsQL 4.0 distinguished between healthy children and children with CP. Construct validity of the CP Module was supported through an analysis of the intercorrelations between the Generic Core Scale scores and the CP Module Scale scores and exploratory factor analysis of PedsQL items. The findings provide support for the measurement properties of the Chinese version PedsQL 4.0 Generic Core Scales and 3.0 CP Module in pediatric CP.

  15. Validity and measurement precision of the PROMIS physical function item bank and a content validity-driven 20-item short form in rheumatoid arthritis compared with traditional measures.

    PubMed

    Oude Voshaar, Martijn A H; Ten Klooster, Peter M; Glas, Cees A W; Vonkeman, Harald E; Taal, Erik; Krishnan, Eswar; Bernelot Moens, Hein J; Boers, Maarten; Terwee, Caroline B; van Riel, Piet L C M; van de Laar, Mart A F J

    2015-12-01

    To evaluate the content validity and measurement properties of the Patient-Reported Outcome Measurement Information System (PROMIS) physical function item bank and a 20-item short form in patients with RA in comparison with the HAQ disability index (HAQ-DI) and 36-item Short Form Health Survey (SF-36) physical functioning scale (PF-10). The content validity of the instruments was evaluated by linking their items to the International Classification of Functioning, Disability and Health (ICF) core set for RA. The measures were administered to 690 RA patients enrolled in the Dutch Rheumatoid Arthritis Monitoring registry. Measurement precision was evaluated using item response theory methods and construct validity was evaluated by correlating physical function scores with other clinical and patient-reported outcome measures. All 207 health concepts identified in the physical function measures referred to activities that are featured in the ICF. Twenty-three of 26 ICF RA core set domains are featured in the full PROMIS physical function item bank compared with 13 and 8 for the HAQ-DI and PF-10, respectively. As hypothesized, all three physical function instruments were highly intercorrelated (r 0.74-0.84), moderately correlated with disease activity measures (r 0.44-0.63) and weakly correlated with age (rs 0.07-0.14). Item response theory-based analysis revealed that a 20-item PROMIS physical function short form covered a wider range of physical function levels than the HAQ-DI or PF-10. The PROMIS physical function item bank demonstrated excellent measurement properties in RA. A content-driven 20-item short form may be a useful tool for assessing physical function in RA. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Idiopathic chronic fatigue in older adults is linked to impaired mitochondrial content and biogenesis signaling in skeletal muscle.

    PubMed

    Wawrzyniak, Nicholas R; Joseph, Anna-Maria; Levin, David G; Gundermann, David M; Leeuwenburgh, Christiaan; Sandesara, Bhanuprasad; Manini, Todd M; Adhihetty, Peter J

    2016-08-16

    Fatigue is a symptom of many diseases, but it can also manifest as a unique medical condition, such as idiopathic chronic fatigue (ICF). While the prevalence of ICF increases with age, mitochondrial content and function decline with age, which may contribute to ICF. The purpose of this study was to determine whether skeletal muscle mitochondrial dysregulation and oxidative stress is linked to ICF in older adults. Sedentary, old adults (n = 48, age 72.4 ± 5.3 years) were categorized into ICF and non-fatigued (NF) groups based on the FACIT-Fatigue questionnaire. ICF individuals had a FACIT score one standard deviation below the mean for non-anemic adults > 65 years and were excluded according to CDC diagnostic criteria for ICF. Vastus lateralis muscle biopsies were analyzed, showing reductions in mitochondrial content and suppression of mitochondrial regulatory proteins Sirt3, PGC-1α, NRF-1, and cytochrome c in ICF compared to NF. Additionally, mitochondrial morphology proteins, antioxidant enzymes, and lipid peroxidation were unchanged in ICF individuals. Our data suggests older adults with ICF have reduced skeletal muscle mitochondrial content and biogenesis signaling that cannot be accounted for by increased oxidative damage.

  17. The International Classification of Functioning, Disability and Health (ICF) in vocational rehabilitation and disability assessment in Slovenia: state of law and users' perspective.

    PubMed

    Ptyushkin, Pavel; Vidmar, Gaj; Burger, Helena; Marinček, Crt; Escorpizo, Reuben

    2011-01-01

    This study illustrates the use of the ICF in vocational rehabilitation and disability assessment in Slovenia. A review of the Slovenian law about vocational rehabilitation was performed. A survey was developed and group and individual interviews were conducted with professionals involved in vocational rehabilitation who use the ICF. The vast majority of the respondents believe that ICF helps to create a common language for multidisciplinary communication. The main advantages of the ICF identified by the respondents are that it provides a holistic view of the person, assesses complexities of functioning, provides a unified language and offers a quick and easy insight into functioning. The disadvantages of ICF are complicated terminology and subjectivity of the assessor. A difficulty encountered by the users is that by law, only body functions of the ICF are assessed. Additional qualitative analysis of the users' understanding of ICF and its purpose revealed heterogeneity. Significant differences between public and private organisations were found. ICF is a promising tool for use in vocational rehabilitation and disability assessment in Slovenia. A major challenge is the lack of interface between ICF and policies on vocational rehabilitation in Slovenia.

  18. The ICF has made a difference to functioning and disability measurement and statistics.

    PubMed

    Madden, Rosamond H; Bundy, Anita

    2018-02-12

    Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and principles, and how the ICF has been used to improve measurement of functioning and related statistics. In a scoping review, we investigated research published 2001-2015 relating to measurement and statistics for evidence of: a change in thinking; alignment of applications with ICF specifications and philosophy; and the emergence of new knowledge. The ICF is used in diverse applications, settings and countries, with processes largely aligned with the ICF and intended to improve measurement and statistics: new national surveys, information systems and ICF-based instruments; and international efforts to improve disability data. Knowledge is growing about the components and interactions of the ICF model, the diverse effects of the environment on functioning, and the meaning and measurement of participation. The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge. Nevertheless, the field needs to mature. Identified gaps suggest ways to improve measurement and statistics to underpin policies, services and outcomes. Implications for Rehabilitation The ICF offers a conceptualization of functioning and disability that can underpin assessment and documentation in rehabilitation, with a growing body of experience to draw on for guidance. Experience with the ICF reminds practitioners to consider all the domains of participation, the effect of the environment on participation and the importance of involving clients/patients in assessment and service planning. Understanding the variability of functioning within everyday environments and designing interventions for removing barriers in various environments is a vital part of rehabilitation planning.

  19. Dilemmas of Korean Athletes With a Spinal Cord Injury to Participate in Sports: A Survey Based on the ICF Core Set for Spinal Cord Injury

    PubMed Central

    2016-01-01

    Objective To explore the experiences of athletes with spinal cord injury (SCI) in Korea with respect to dilemmas of participating in sports with regards to the facilitators and barriers, using the International Classification of Functioning, Disability and Health (ICF). Methods The facilitators and barriers to sports participation of individuals with SCI were examined using 112 ICF categories. A questionnaire in dichotomous scale was answered, which covered the subjects 'Body functions', 'Body structures', 'Activity and participation' and 'Environmental factors'. Data analysis included the use of descriptive statistics to examine the frequency and magnitude of reported issues. Results Sixty-two community-dwelling participants were recruited. Frequently addressed barriers in 'Body functions' were mobility related problems such as muscle and joint problems, bladder and bowel functions, pressure ulcers, and pain. In 'Activity and participation', most frequently reported were mobility and self-care problems. Highly addressed barriers in 'Environmental factors' were sports facilities, financial cost, transportation problems and lack of information. Relationships such as peer, family and friends were the most important facilitators. Conclusion Numerous barriers still exist for SCI survivors to participate in sports, especially in the area of health care needs and environmental factors. Our results support the need for a multidisciplinary approach to promote sports participation. PMID:27847720

  20. Most common problems across health conditions as described by the International Classification of Functioning, Disability, and Health.

    PubMed

    Ptyushkin, Pavel; Cieza, Alarcos; Stucki, Gerold

    2015-09-01

    Health conditions are associated with a variety of functional outcomes. Even though functional outcomes are diverse for different health conditions, they can have important commonalities. The aim of this study was to identify the most common problems in functioning across the wide range of health conditions using the International Classification of Functioning (ICF). Existing databases created for the 21 ICF Core Sets studies were descriptively analyzed. These included data collected in 44 countries on 9978 patients with one of 21 health conditions as the main diagnosis. A frequency cutoff of 50% was used to identify the most common problems in functioning when looking at single health conditions and across them. No category was identified as common to all health conditions included in the study. Fifteen most frequent categories were common in 10 to 13 health conditions out of 21. Eleven categories correspond to the list of activities and participation, and four to the list of body functions. These are related to mobility, daily routine, mental functions, intimate relations, employment, and leisure. Some health conditions have more commonalities between each other. The most common problems across health conditions are therefore related to mental functions, mobility, daily life, intimate relations, employment, and leisure. The results contribute toward the identification of the universal set of ICF categories that can be used in clinical practice for the general assessment of functioning.

  1. Measuring health-related quality of life in children with cancer living in Mainland China: feasibility, reliability and validity of the Chinese Mandarin version of PedsQL 4.0 Generic Core Scales and 3.0 Cancer Module.

    PubMed

    Ji, Yi; Chen, Siyuan; Li, Kai; Xiao, Nong; Yang, Xue; Zheng, Shan; Xiao, Xianmin

    2011-11-23

    The Pediatric Quality of Life Inventory (PedsQL) is widely used instrument to measure pediatric health-related quality of life (HRQOL) for children aged 2 to 18 years. The purpose of the current study was to investigate the feasibility, reliability and validity of the Chinese mandarin version of the PedsQL 4.0 Generic Core Scales and 3.0 Cancer Module in a group of Chinese children with cancer. The PedsQL 4.0 Genetic Core Scales and the PedsQL 3.0 Cancer Module were administered to children with cancer (aged 5-18 years) and parents of such children (aged 2-18 years). For comparison, a survey on a demographically group-matched sample of the general population with children (aged 5-18) and parents of children (aged 2-18 years) was conducted with the PedsQL 4.0 Genetic Core Scales. The minimal mean percentage of missing item responses (except the School Functioning scale) supported the feasibility of the PedsQL 4.0 Generic Core Scales and 3.0 Cancer Module for Chinese children with cancer. Most of the scales showed satisfactory reliability with Cronbach's α of exceeding 0.70, and all scales demonstrated sufficient test-retest reliability. Assessing the clinical validity of the questionnaires, statistically significant difference was found between healthy children and children with cancer, and between children on-treatment versus off-treatment ≥12 months. Positive significant correlations were observed between the scores of the PedsQL 4.0 Generic Core Scale and the PedsQL 3.0 Cancer Module. Exploratory factor analysis demonstrated sufficient factorial validity. Moderate to good agreement was found between child self- and parent proxy-reports. The findings support the feasibility, reliability and validity of the Chinese Mandarin version of PedsQL 4.0 Generic Core Scales and 3.0 Cancer Module in children with cancer living in mainland China.

  2. Measuring health-related quality of life in children with cancer living in mainland China: feasibility, reliability and validity of the Chinese mandarin version of PedsQL 4.0 Generic Core Scales and 3.0 Cancer Module

    PubMed Central

    2011-01-01

    Background The Pediatric Quality of Life Inventory (PedsQL) is widely used instrument to measure pediatric health-related quality of life (HRQOL) for children aged 2 to 18 years. The purpose of the current study was to investigate the feasibility, reliability and validity of the Chinese mandarin version of the PedsQL 4.0 Generic Core Scales and 3.0 Cancer Module in a group of Chinese children with cancer. Methods The PedsQL 4.0 Genetic Core Scales and the PedsQL 3.0 Cancer Module were administered to children with cancer (aged 5-18 years) and parents of such children (aged 2-18 years). For comparison, a survey on a demographically group-matched sample of the general population with children (aged 5-18) and parents of children (aged 2-18 years) was conducted with the PedsQL 4.0 Genetic Core Scales. Result The minimal mean percentage of missing item responses (except the School Functioning scale) supported the feasibility of the PedsQL 4.0 Generic Core Scales and 3.0 Cancer Module for Chinese children with cancer. Most of the scales showed satisfactory reliability with Cronbach's α of exceeding 0.70, and all scales demonstrated sufficient test-retest reliability. Assessing the clinical validity of the questionnaires, statistically significant difference was found between healthy children and children with cancer, and between children on-treatment versus off-treatment ≥12 months. Positive significant correlations were observed between the scores of the PedsQL 4.0 Generic Core Scale and the PedsQL 3.0 Cancer Module. Exploratory factor analysis demonstrated sufficient factorial validity. Moderate to good agreement was found between child self- and parent proxy-reports. Conclusion The findings support the feasibility, reliability and validity of the Chinese Mandarin version of PedsQL 4.0 Generic Core Scales and 3.0 Cancer Module in children with cancer living in mainland China. PMID:22111968

  3. Exploring use of the ICF in health education.

    PubMed

    Bornbaum, Catherine C; Day, Adam M B; Izaryk, Kristen; Morrison, Stephanie J; Ravenek, Michael J; Sleeth, Lindsay E; Skarakis-Doyle, Elizabeth

    2015-01-01

    Currently, little is known regarding use of the International Classification of Functioning, Disability and Health (ICF) in health education applications. Therefore, this review sought to examine the scope of work that has been conducted regarding the application of the ICF in health education. A review of the current literature related to use of the ICF in health education programs was conducted. Twelve electronic databases were searched in accordance with a search protocol developed by a health sciences librarian. In total, 17,878 records were reviewed, and 18 articles met the criteria for inclusion in this review. Current evidence regarding use of the ICF in healthcare education revealed that program and participant properties can be essential facilitators or barriers to successful education programs. In addition, gaps in comprehensive outcome measurement were revealed as areas for future attention. Educational applications of the ICF are very much a work in progress as might be expected given the ICF's existence for only a little over a decade. To advance use of the ICF in education, it is important to incorporate the measurement of both knowledge acquisition and behavior change related to ICF-based programs. Ultimately, widespread implementation of the ICF represents not only a substantial opportunity but also poses a significant challenge.

  4. X-ray penumbral imaging diagnostic developments at the National Ignition Facility

    NASA Astrophysics Data System (ADS)

    Bachmann, B.; Abu-Shawareb, H.; Alexander, N.; Ayers, J.; Bailey, C. G.; Bell, P.; Benedetti, L. R.; Bradley, D.; Collins, G.; Divol, L.; Döppner, T.; Felker, S.; Field, J.; Forsman, A.; Galbraith, J. D.; Hardy, C. M.; Hilsabeck, T.; Izumi, N.; Jarrot, C.; Kilkenny, J.; Kramer, S.; Landen, O. L.; Ma, T.; MacPhee, A.; Masters, N.; Nagel, S. R.; Pak, A.; Patel, P.; Pickworth, L. A.; Ralph, J. E.; Reed, C.; Rygg, J. R.; Thorn, D. B.

    2017-08-01

    X-ray penumbral imaging has been successfully fielded on a variety of inertial confinement fusion (ICF) capsule implosion experiments on the National Ignition Facility (NIF). We have demonstrated sub-5 μm resolution imaging of stagnated plasma cores (hot spots) at x-ray energies from 6 to 30 keV. These measurements are crucial for improving our understanding of the hot deuterium-tritium fuel assembly, which can be affected by various mechanisms, including complex 3-D perturbations caused by the support tent, fill tube or capsule surface roughness. Here we present the progress on several approaches to improve x-ray penumbral imaging experiments on the NIF. We will discuss experimental setups that include penumbral imaging from multiple lines-of-sight, target mounted penumbral apertures and variably filtered penumbral images. Such setups will improve the signal-to-noise ratio and the spatial imaging resolution, with the goal of enabling spatially resolved measurements of the hot spot electron temperature and material mix in ICF implosions.

  5. Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.

    PubMed

    Stucki, Gerold; Zampolini, Mauro; Juocevicius, Alvydas; Negrini, Stefano; Christodoulou, Nicolas

    2017-04-01

    Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

  6. Readability and Content Assessment of Informed Consent Forms for Phase II-IV Clinical Trials in China

    PubMed Central

    Wen, Gaiyan; Liu, Xinchun; Huang, Lihua; Shu, Jingxian; Xu, Nana; Chen, Ruifang; Huang, Zhijun; Yang, Guoping; Wang, Xiaomin; Xiang, Yuxia; Lu, Yao; Yuan, Hong

    2016-01-01

    Purpose To explore the readability and content integrity of informed consent forms (ICFs) used in China and to compare the quality of Chinese local ICFs with that of international ICFs. Methods The length, readability and content of 155 consent documents from phase II-IV drug clinical trials from the Third Xiangya Hospital Ethics Committee from November 2009 to January 2015 were evaluated. Reading difficulty was tested using a readability formula adapted for the Chinese language. An ICF checklist containing 27 required elements was successfully constructed to evaluate content integrity. The description of alternatives to participation was assessed. The quality of ICFs from different sponsorships were also compared. Results Among the 155 evaluable trials, the ICFs had a median length of 5286 words, corresponding to 7 pages. The median readability score was 4.31 (4.02–4.41), with 63.9% at the 2nd level and 36.1% at the 3rd level. Five of the 27 elements were frequently neglected. The average score for the description of alternatives to participation was 1.06, and 27.7% of the ICFs did not mention any alternatives. Compared with Chinese local ICFs, international ICFs were longer, more readable and contained more of the required elements (P < 0.05). Conclusion The ICFs used in China were difficult to read for most participants. These forms had poor description of alternatives to participation, and failed to provide a high degree of information disclosure, including an explanation of informed consent, follow-up processing of the data/sample, inclusion/exclusion criteria, double blinding, and unpredictable risks. International ICFs had better readability and content integrity than Chinese local ICFs. More efforts should thus be made to improve the quality of consent documents in China. PMID:27701471

  7. Readability and Content Assessment of Informed Consent Forms for Phase II-IV Clinical Trials in China.

    PubMed

    Wen, Gaiyan; Liu, Xinchun; Huang, Lihua; Shu, Jingxian; Xu, Nana; Chen, Ruifang; Huang, Zhijun; Yang, Guoping; Wang, Xiaomin; Xiang, Yuxia; Lu, Yao; Yuan, Hong

    2016-01-01

    To explore the readability and content integrity of informed consent forms (ICFs) used in China and to compare the quality of Chinese local ICFs with that of international ICFs. The length, readability and content of 155 consent documents from phase II-IV drug clinical trials from the Third Xiangya Hospital Ethics Committee from November 2009 to January 2015 were evaluated. Reading difficulty was tested using a readability formula adapted for the Chinese language. An ICF checklist containing 27 required elements was successfully constructed to evaluate content integrity. The description of alternatives to participation was assessed. The quality of ICFs from different sponsorships were also compared. Among the 155 evaluable trials, the ICFs had a median length of 5286 words, corresponding to 7 pages. The median readability score was 4.31 (4.02-4.41), with 63.9% at the 2nd level and 36.1% at the 3rd level. Five of the 27 elements were frequently neglected. The average score for the description of alternatives to participation was 1.06, and 27.7% of the ICFs did not mention any alternatives. Compared with Chinese local ICFs, international ICFs were longer, more readable and contained more of the required elements (P < 0.05). The ICFs used in China were difficult to read for most participants. These forms had poor description of alternatives to participation, and failed to provide a high degree of information disclosure, including an explanation of informed consent, follow-up processing of the data/sample, inclusion/exclusion criteria, double blinding, and unpredictable risks. International ICFs had better readability and content integrity than Chinese local ICFs. More efforts should thus be made to improve the quality of consent documents in China.

  8. Mapping the Content of the Patient Reported Outcomes Measurement Information System (PROMIS®) Using the International Classification of Functioning, Health and Disability

    PubMed Central

    Tucker, Carole A; Escorpizo, Reuben; Cieza, Alarcos; Lai, Jin Shei; Stucki, Gerold; Ustun, T. Bedirhan; Kostanjsek, Nenad; Cella, David; Forrest, Christopher B.

    2014-01-01

    Background The Patient Reported Outcomes Measurement Information System (PROMIS®) is a U.S. National Institutes of Health initiative that has produced self-reported item banks for physical, mental, and social health. Objective To describe the content of PROMIS at the item level using the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). Methods All PROMIS adult items (publicly available as of 2012) were assigned to relevant ICF concepts. The content of the PROMIS adult item banks were then described using the mapped ICF code descriptors. Results The 1006 items in the PROMIS instruments could all be mapped to ICF concepts at the second level of classification, with the exception of 3 items of global or general health that mapped across the first-level classification of ICF activity and participation component (d categories). Individual PROMIS item banks mapped from 1 to 5 separate ICF codes indicating one-to-one, one-to-many and many-to-one mappings between PROMIS item banks and ICF second level classification codes. PROMIS supports measurement of the majority of major concepts in the ICF Body Functions (b) and Activity & Participation (d) components using PROMIS item banks or subsets of PROMIS items that could, with care, be used to develop customized instruments. Given the focus of PROMIS is on measurement of person health outcomes, concepts in body structures (s) and some body functions (b), as well as many ICF environmental factor have minimal coverage in PROMIS. Discussion The PROMIS-ICF mapped items provide a basis for users to evaluate the ICF related content of specific PROMIS instruments, and to select PROMIS instruments in ICF based measurement applications. PMID:24760532

  9. Measuring the impact and distress of health problems from the individual's perspective: development of the Perceived Impact of Problem Profile (PIPP)

    PubMed Central

    Pallant, Julie F; Misajon, RoseAnne; Bennett, Elizabeth; Manderson, Lenore

    2006-01-01

    Background The aim of this study was to develop and conduct preliminary validation of the Perceived Impact of Problem Profile (PIPP). Based on the biopsychosocial model of health and functioning, the PIPP was intended as a generic research and clinical measurement tool to assess the impact and distress of health conditions from the individuals' perspective. The ICF classification system was used to guide the structure of the PIPP with subscales included to assess impact on self-care, mobility, participation, relationships and psychological well-being. While the ICF focuses on the classification of objective health and health related status, the PIPP broadens this focus to address the individuals' subjective experience of their health condition. Methods An item pool of 23 items assessing both impact and distress on five key domains was generated. These were administered to 169 adults with mobility impairment. Rasch analysis using RUMM2020 was conducted to assess the psychometric properties of each set of items. Preliminary construct validation of the PIPP was performed using the EQ5D. Results For both the Impact and Distress scales of the PIPP, the five subscales (Self-care, Mobility, Participation, Relationships, and Psychological Well-being) showed adequate psychometric properties, demonstrating fit to the Rasch model. All subscales showed adequate person separation reliability and no evidence of differential item functioning for sex, age, educational level or rural vs urban residence. Preliminary validity testing using the EQ5D items provided support for the subscales. Conclusion This preliminary study, using a sample of adults with mobility impairment, provides support for the psychometric properties of the PIPP as a potential clinical and research measurement tool. The PIPP provides a brief, but comprehensive means to assess the key ICF components, focusing on the individuals' perspective of the impact and distress caused by their health condition. Further validation of its use across different health conditions and varying cultural settings is required. PMID:16808842

  10. Elements of progressive patient care in the Yale Health Plan HMO.

    PubMed

    Pearson, D A; Rowe, D S; Goldberg, B; Seigel, E

    1975-01-01

    The results of a study of the use of intermediate care beds in the intermediate care facility (ICF) of the Yale Health Plan, a prepaid group practice plan for students and an enrolled non-student population, indicate that the ICF may be a possible model for other health maintenance organizations. The ICF, with 30 beds in active use, is located in the Yale health center. Approximately one-third of the ICF patients would have been admitted to the affiliated short-term general hospital if the ICF did not exist. The plan's medical staff also has the option of transferring patients between the affiliated hospital and the ICF, depending on which institution is most appropriate for the patient's needs. A comparison of the levels of care provided in the ICF with those presented in selected articles from the progressive patient care literature revealed that the ICF is not only providing intermediate care but several other classic elements of progressive patient care -self care, continuing care, minimal care, and partial care.

  11. Elements of progressive patient care in the Yale Health Plan HMO.

    PubMed Central

    Pearson, D A; Rowe, D S; Goldberg, B; Seigel, E

    1975-01-01

    The results of a study of the use of intermediate care beds in the intermediate care facility (ICF) of the Yale Health Plan, a prepaid group practice plan for students and an enrolled non-student population, indicate that the ICF may be a possible model for other health maintenance organizations. The ICF, with 30 beds in active use, is located in the Yale health center. Approximately one-third of the ICF patients would have been admitted to the affiliated short-term general hospital if the ICF did not exist. The plan's medical staff also has the option of transferring patients between the affiliated hospital and the ICF, depending on which institution is most appropriate for the patient's needs. A comparison of the levels of care provided in the ICF with those presented in selected articles from the progressive patient care literature revealed that the ICF is not only providing intermediate care but several other classic elements of progressive patient care -self care, continuing care, minimal care, and partial care. PMID:805444

  12. Comparison between Utility of the Thai Pediatric Quality of Life Inventory 4.0 Generic Core Scales and 3.0 Cerebral Palsy Module

    ERIC Educational Resources Information Center

    Tantilipikorn, Pinailug; Watter, Pauline; Prasertsukdee, Saipin

    2013-01-01

    Health-related quality of life (HRQOL) is increasingly being considered in the management of patients with various conditions. HRQOL instruments can be broadly classified as generic or disease-specific measures. Several generic HRQOL instruments in different languages have been developed for paediatric populations including the Pediatric Quality…

  13. Health measurement using the ICF: Test-retest reliability study of ICF codes and qualifiers in geriatric care

    PubMed Central

    Okochi, Jiro; Utsunomiya, Sakiko; Takahashi, Tai

    2005-01-01

    Background The International Classification of Functioning, Disability and Health (ICF) was published by the World Health Organization (WHO) to standardize descriptions of health and disability. Little is known about the reliability and clinical relevance of measurements using the ICF and its qualifiers. This study examines the test-retest reliability of ICF codes, and the rate of immeasurability in long-term care settings of the elderly to evaluate the clinical applicability of the ICF and its qualifiers, and the ICF checklist. Methods Reliability of 85 body function (BF) items and 152 activity and participation (AP) items of the ICF was studied using a test-retest procedure with a sample of 742 elderly persons from 59 institutional and at home care service centers. Test-retest reliability was estimated using the weighted kappa statistic. The clinical relevance of the ICF was estimated by calculating immeasurability rate. The effect of the measurement settings and evaluators' experience was analyzed by stratification of these variables. The properties of each item were evaluated using both the kappa statistic and immeasurability rate to assess the clinical applicability of WHO's ICF checklist in the elderly care setting. Results The median of the weighted kappa statistics of 85 BF and 152 AP items were 0.46 and 0.55 respectively. The reproducibility statistics improved when the measurements were performed by experienced evaluators. Some chapters such as genitourinary and reproductive functions in the BF domain and major life area in the AP domain contained more items with lower test-retest reliability measures and rated as immeasurable than in the other chapters. Some items in the ICF checklist were rated as unreliable and immeasurable. Conclusion The reliability of the ICF codes when measured with the current ICF qualifiers is relatively low. The result in increase in reliability according to evaluators' experience suggests proper education will have positive effects to raise the reliability. The ICF checklist contains some items that are difficult to be applied in the geriatric care settings. The improvements should be achieved by selecting the most relevant items for each measurement and by developing appropriate qualifiers for each code according to the interest of the users. PMID:16050960

  14. Inertial Confinement Fusion Annual Report 1997

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Correll, D

    The ICF Annual Report provides documentation of the achievements of the LLNL ICF Program during the fiscal year by the use of two formats: (1) an Overview that is a narrative summary of important results for the fiscal year and (2) a compilation of the articles that previously appeared in the ICF Quarterly Report that year. Both the Overview and Quarterly Report are also on the Web at http://lasers.llnl.gov/lasers/pubs/icfq.html. Beginning in Fiscal Year 1997, the fourth quarter issue of the ICF Quarterly was no longer printed as a separate document but rather included in the ICF Annual. This change providedmore » a more efficient process of documenting our accomplishments with-out unnecessary duplication of printing. In addition we introduced a new document, the ICF Program Monthly Highlights. Starting with the September 1997 issue and each month following, the Monthly Highlights will provide a brief description of noteworthy activities of interest to our DOE sponsors and our stakeholders. The underlying theme for LLNL's ICF Program research continues to be defined within DOE's Defense Programs missions and goals. In support of these missions and goals, the ICF Program advances research and technology development in major interrelated areas that include fusion target theory and design, target fabrication, target experiments, and laser and optical science and technology. While in pursuit of its goal of demonstrating thermonuclear fusion ignition and energy gain in the laboratory, the ICF Program provides research and development opportunities in fundamental high-energy-density physics and supports the necessary research base for the possible long-term application of inertial fusion energy for civilian power production. ICF technologies continue to have spin-off applications for additional government and industrial use. In addition to these topics, the ICF Annual Report covers non-ICF funded, but related, laser research and development and associated applications. We also provide a short summary of the quarterly activities within Nova laser operations, Beamlet laser operations, and National Ignition Facility laser design. LLNL's ICF Program falls within DOE's national ICF program, which includes the Nova and Beamlet (LLNL), OMEGA (University of Rochester Laboratory for Laser Energetics), Nike (Naval Research Laboratory), and Trident (Los Alamos National Laboratory) laser facilities. The Particle Beam Fusion Accelerator (Z) and Saturn pulsed-power facilities are at Sandia National Laboratories. General Atomics, Inc., develops and provides many of the targets for the above experimental facilities. Many of the ICF Annual Report articles are co-authored with our colleagues from these other ICF institutions.« less

  15. Evaluation of two (125)I-radiolabeled acridine derivatives for Auger-electron radionuclide therapy of melanoma.

    PubMed

    Gardette, Maryline; Viallard, Claire; Paillas, Salomé; Guerquin-Kern, Jean-Luc; Papon, Janine; Moins, Nicole; Labarre, Pierre; Desbois, Nicolas; Wong-Wah-Chung, Pascal; Palle, Sabine; Wu, Ting-Di; Pouget, Jean-Pierre; Miot-Noirault, Elisabeth; Chezal, Jean-Michel; Degoul, Francoise

    2014-08-01

    We previously selected two melanin-targeting radioligands [(125)I]ICF01035 and [(125)I]ICF01040 for melanoma-targeted (125)I radionuclide therapy according to their pharmacological profile in mice bearing B16F0 tumors. Here we demonstrate in vitro that these compounds present different radiotoxicities in relation to melanin and acidic vesicle contents in B16F0, B16F0 PTU and A375 cell lines. ICF01035 is effectively observed in nuclei of achromic (A375) melanoma or in melanosomes of melanized melanoma (B16F0), while ICF01040 stays in cytoplasmic vesicles in both cells. [(125)I]ICF01035 induced a similar survival fraction (A50) in all cell lines and led to a significant decrease in S-phase cells in amelanotic cell lines. [(125)I]ICF01040 induced a higher A50 in B16 cell lines compared to [(125)I]ICF01035 ones. [(125)I]ICF01040 induced a G2/M blockade in both A375 and B16F0 PTU, associated with its presence in cytoplasmic acidic vesicles. These results suggest that the radiotoxicity of [(125)I]ICF01035 and [(125)I]ICF01040 are not exclusively reliant on DNA alterations compatible with γ rays but likely result from local dose deposition (Auger electrons) leading to toxic compound leaks from acidic vesicles. In vivo, [(125)I]ICF01035 significantly reduced the number of B16F0 lung colonies, enabling a significant increase in survival of the treated mice. Targeting melanosomes or acidic vesicles is thus an option for future melanoma therapy.

  16. 42 CFR 440.150 - Intermediate care facility (ICF/IIDICF/IID) services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Intermediate care facility (ICF/IIDICF/IID... Definitions § 440.150 Intermediate care facility (ICF/IIDICF/IID) services. (a) “ICF/IIDICF/IID services” means those items and services furnished in an intermediate care facility for Individuals with...

  17. 42 CFR 440.150 - Intermediate care facility (ICF/IIDICF/IID) services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Intermediate care facility (ICF/IIDICF/IID... Definitions § 440.150 Intermediate care facility (ICF/IIDICF/IID) services. (a) “ICF/IIDICF/IID services” means those items and services furnished in an intermediate care facility for Individuals with...

  18. Validity and reliability of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) Generic Core Scales in children

    PubMed Central

    2012-01-01

    Background This study aimed to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in children. Methods A standard forward and backward translation procedure was used to translate the US English version of the PedsQL™ 4.0 Generic Core Scales for children into the Iranian language (Persian). The Iranian version of the PedsQL™ 4.0 Generic Core Scales was completed by 503 healthy and 22 chronically ill children aged 8-12 years and their parents. The reliability was evaluated using internal consistency. Known-groups discriminant comparisons were made, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Results The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.70. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between the children self-report and parent proxy-reports showed moderate to high agreement. Exploratory factor analysis extracted six factors from the PedsQL™ 4.0 for both self and proxy reports, accounting for 47.9% and 54.8% of total variance, respectively. The results of the confirmatory factor analysis for 6-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding health status, as hypothesized from previous studies, healthy children reported significantly higher health-related quality of life than those with chronic illnesses. Conclusions The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure health-related quality of life of children in Iran. PMID:22221765

  19. Validity and reliability of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) Generic Core Scales in children.

    PubMed

    Amiri, Parisa; Eslamian, Ghazaleh; Mirmiran, Parvin; Shiva, Niloofar; Jafarabadi, Mohammad Asghari; Azizi, Fereidoun

    2012-01-05

    This study aimed to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in children. A standard forward and backward translation procedure was used to translate the US English version of the PedsQL™ 4.0 Generic Core Scales for children into the Iranian language (Persian). The Iranian version of the PedsQL™ 4.0 Generic Core Scales was completed by 503 healthy and 22 chronically ill children aged 8-12 years and their parents. The reliability was evaluated using internal consistency. Known-groups discriminant comparisons were made, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.70. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between the children self-report and parent proxy-reports showed moderate to high agreement. Exploratory factor analysis extracted six factors from the PedsQL™ 4.0 for both self and proxy reports, accounting for 47.9% and 54.8% of total variance, respectively. The results of the confirmatory factor analysis for 6-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding health status, as hypothesized from previous studies, healthy children reported significantly higher health-related quality of life than those with chronic illnesses. The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure health-related quality of life of children in Iran.

  20. Effect of insulating concrete forms in concrete compresive strength

    NASA Astrophysics Data System (ADS)

    Martinez Jerez, Silvio R.

    The subject presented in this thesis is the effect of Insulating Concrete Forms (ICF's) on concrete compressive strength. This work seeks to identify if concrete cured in ICF's has an effect in compressive strength due to the thermal insulation provided by the forms. Modern construction is moving to energy efficient buildings and ICF's is becoming more popular in new developments. The thesis used a concrete mixture and a mortar mixture to investigate the effects of ICF's on concrete compressive strength. After the experimentations were performed, it was concluded that the ICF's do affect concrete strength. It was found that the forms increase concrete strength without the need for additional curing water. An increase of 50% in strength at 56 days was obtained. It was concluded that the longer concrete cures inside ICF's, the higher strength it reaches, and that ICF's effect on concrete strength is proportional to volume of concrete.

  1. 42 CFR 440.150 - Intermediate care facility (ICF/MR) services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Intermediate care facility (ICF/MR) services. 440....150 Intermediate care facility (ICF/MR) services. (a) “ICF/MR services” means those items and services furnished in an intermediate care facility for the mentally retarded if the following conditions are met: (1...

  2. State Medicaid ICF-MR Utilization and Expenditures in the 1980-1984 Period.

    ERIC Educational Resources Information Center

    Harrington, Charlene; Swan, James H.

    1990-01-01

    State Medicaid expenditures for Intermediate Care Facilities for the Mentally Retarded (ICF-MR) increased sharply between 1980 and 1984. The ICF-MR bed capacity declined relative to the total state population, while numbers of ICF-MR Medicaid recipients increased. Trends among states are examined, emphasizing changes in demographic factors,…

  3. The ICF and Postsurgery Occupational Therapy after Traumatic Hand Injury

    ERIC Educational Resources Information Center

    Fitinghoff, Helene; Lindqvist, Birgitta; Nygard, Louise; Ekholm, Jan; Schult, Marie-Louise

    2011-01-01

    Recent studies have examined the effectiveness of hand rehabilitation programmes and have linked the outcomes to the concept of ICF but not to specific ICF category codes. The objective of this study was to gain experience using ICF concepts to describe occupational therapy interventions during postsurgery hand rehabilitation, and to describe…

  4. Exploring changes over time in habilitation professionals' perceptions and applications of the International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY).

    PubMed

    Adolfsson, Margareta; Granlund, Mats; Björck-Akesson, Eva; Ibragimova, Nina; Pless, Mia

    2010-07-01

    This study explored how professionals in inter-disciplinary teams perceived the implementation of the World Health Organization's International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) in Swedish habilitation services. Descriptive longitudinal mixed-methods design. Following participation in a 2-day in-service training on the ICF-CY, 113 professionals from 14 interdisciplinary teams described their perceptions of the implementation of the ICF-CY at 3 consecutive time-points: during in-service training, after 1 year, and after 2.5 years. Implementation of the ICF-CY in daily work focused on assessment and habilitation planning and required adaptations of routines and materials. The ICF-CY was perceived as useful in supporting analyses and in communication about children's needs. Professionals also perceived it as contributing to new perspectives on problems and a sharpened focus on participation. Professionals indicated that the ICF-CY enhanced their awareness of families' views of child participation, which corresponded to organizational goals for habilitation services. An implementation finding was a lack of tools fitting the comprehensive ICF-CY perspective. The study points to the need for ICF-CY-based assessment and intervention methods focusing on child participation.

  5. [Introduction of an accreditation system for hospital informed consent forms].

    PubMed

    López-Picazo, J J; Tomás-Garcia, N; Calle-Urra, J E; Parra-Hidalgo, P; Valverde-Iniesta, J J

    2015-01-01

    To describe an accreditation system for informed consent forms (ICF) in a tertiary hospital, as an intervention to improve their quality, and to check the improvements achieved. Following an external evaluation of the ICF quality in a public hospital in Murcia (Spain), an accreditation committee set the ICF requirements and associated procedures. Effectiveness is assessed by comparing two external evaluations carried out by the EMCA Program (2011 and 2013) and based on 19 criteria and a sample of 60 ICF for every public hospital in Murcia Region. To be accredited, every ICF must meet the 19 external criteria plus 5 based on legibility, readability and scientific and technical validity. A form to fill in the contents of every ICF was agreed, which would be reviewed, approved and validated for five years. Before the implementation, 8.2 defects/ICF were detected. The accreditation system obtained an 89% improvement (0.9 defects/ICF) and achieved significant improvements in 18 criteria, 16 of which are benchmarked. The accreditation system achieved a substantial improvement in the ICF (obtaining a better result in external evaluations) and guarantees their contents, legibility and readability. This system needs to be extended to other hospitals, since it is not clear whether common ICFs would be suitable. However, this improvement is structural and does not guarantee that the overall information/consent procedure is done properly, thus complementary strategies for measurement and improvement are required. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  6. Improved participants' understanding of research information in real settings using the SIDCER informed consent form: a randomized-controlled informed consent study nested with eight clinical trials.

    PubMed

    Koonrungsesomboon, Nut; Tharavanij, Thipaporn; Phiphatpatthamaamphan, Kittichet; Vilaichone, Ratha-Korn; Manuwong, Sudsayam; Curry, Parichat; Siramolpiwat, Sith; Punchaipornpon, Thanachai; Kanitnate, Supakit; Tammachote, Nattapol; Yamprasert, Rodsarin; Chanvimalueng, Waipoj; Kaewkumpai, Ruchirat; Netanong, Soiphet; Kitipawong, Peerapong; Sritipsukho, Paskorn; Karbwang, Juntra

    2017-02-01

    This study aimed to test the applicability and effectiveness of the principles and informed consent form (ICF) template proposed by the Strategic Initiative for Developing Capacity in Ethical Review (SIDCER) across multiple clinical trials involving Thai research participants with various conditions. A single-center, randomized-controlled study nested with eight clinical trials was conducted at Thammasat University Hospital, Thailand. A total of 258 participants from any of the eight clinical trials were enrolled and randomly assigned to read either the SIDCER ICF (n = 130) or the conventional ICF (n = 128) of the respective trial. Their understanding of necessary information was assessed using the post-test questionnaire; they were allowed to consult a given ICF while completing the questionnaire. The primary endpoint was the proportion of the participants who had the post-test score of ≥80%, and the secondary endpoint was the total score of the post-test. The proportion of the participants in the SIDCER ICF group who achieved the primary endpoint was significantly higher than that of the conventional ICF group (60.8 vs. 41.4%, p = 0.002). The total score of the post-test was also significantly higher among the participants who read the SIDCER ICF than those who read the conventional ICF (83.3 vs. 76.0%, p < 0.001). The present study demonstrated that the SIDCER ICF was applicable and effective to improve Thai research participants' understanding of research information in diverse clinical trials. Using the SIDCER ICF methodology, clinical researchers can improve the quality of ICFs for their trials.

  7. Extracellular Fluid/Intracellular Fluid Volume Ratio as a Novel Risk Indicator for All-Cause Mortality and Cardiovascular Disease in Hemodialysis Patients

    PubMed Central

    Kim, Eun-Jung; Choi, Myung-Jin; Lee, Jeoung-Hwan; Oh, Ji-Eun; Seo, Jang-Won; Lee, Young-Ki; Yoon, Jong-Woo; Kim, Hyung-Jik; Noh, Jung-Woo

    2017-01-01

    Background In hemodialysis patients, fluid overload and malnutrition are accompanied by extracellular fluid (ECF) expansion and intracellular fluid (ICF) depletion, respectively. We investigated the relationship between ECF/ICF ratio (as an integrated marker reflecting both fluid overload and malnutrition) and survival and cardiovascular disease (CVD) in the context of malnutrition-inflammation-arteriosclerosis (MIA) complex. Methods Seventy-seven patients from a single hemodialysis unit were prospectively enrolled. The ECF/ICF volume was measured by segmental multi-frequency bioimpedance analysis. MIA and volume status were measured by serum albumin, C-reactive protein (CRP), pulse wave velocity (PWV) and plasma B-type natriuretic peptide (BNP), respectively. Results The mean ECF/ICF ratio was 0.56±0.06 and the cut-off value for maximum discrimination of survival was 0.57. Compared with the low ECF/ICF group, the high ECF/ICF group (ratio≥0.57, 42%) had higher all-cause mortality, CVD, CRP, PWV, and BNP, but lower serum albumin. During the 5-year follow-up, 24 all-cause mortality and 38 CVD occurred (18 and 24, respectively, in the high ECF/ICF group versus 6 and 14 respectively in the low ECF/ICF group, P<0.001). In the adjusted Cox analysis, the ECF/ICF ratio nullifies the effects of the MIA and volume status on survival and CVD and was an independent predictor of all-cause mortality and CVD: hazard ratio (95% confidence interval); 1.12 (1.01–1.25) and 1.09 (1.01–1.18) for a 0.01 increase in the ECF/ICF ratio. The degree of malnutrition (albumin), inflammation (CRP), arteriosclerosis (PWV), and fluid overload (BNP) were correlated well with the ECF/ICF ratio. Conclusions Hemodialysis patients with high ECF/ICF ratio are not only fluid overloaded, but malnourished and have stiff artery with more inflammation. The ECF/ICF ratio is highly related to the MIA complex, and is a major risk indicator for all-cause mortality and CVD. PMID:28099511

  8. A booklet on participants' rights to improve consent for clinical research: a randomized trial.

    PubMed

    Benatar, Jocelyne R; Mortimer, John; Stretton, Matthew; Stewart, Ralph A H

    2012-01-01

    Information on the rights of subjects in clinical trials has become increasingly complex and difficult to understand. This study evaluates whether a simple booklet which is relevant to all research studies improves the understanding of rights needed for subjects to provide informed consent. 21 currently used informed consent forms (ICF) from international clinical trials were separated into information related to the specific research study, and general information on participants' rights. A booklet designed to provide information on participants' rights which used simple language was developed to replace this information in current ICF's Readability of each component of ICF's and the booklet was then assessed using the Flesch-Kincaid Reading ease score (FK). To further evaluate the booklet 282 hospital inpatients were randomised to one of three ways to present research information; a standard ICF, the booklet combined with a short ICF, or the booklet combined with a simplified ICF. Comprehension of information related to the research proposal and to participant's rights was assessed by questionnaire. Information related to participants' rights contributed an average of 44% of the words in standard ICFs, and was harder to read than information describing the clinical trial (FK 25 versus (vs.) 41 respectively, p = 0.0003). The booklet reduced the number of words and improved FK from 25 to 42. The simplified ICF had a slightly higher FK score than the standard ICF (50 vs. 42). Comprehension assessed in inpatients was better for the booklet and short ICF 62%, (95% confidence interval (CI) 56 to 67) correct, or simplified ICF 62% (CI 58 to 68) correct compared to 52%, (CI 47 to 57) correct for the standard ICF, p = 0.009. This was due to better understanding of questions on rights (62% vs. 49% correct, p = 0.0008). Comprehension of study related information was similar for the simplified and standard ICF (60% vs. 64% correct, p = 0.68). A booklet provides a simple consistent approach to providing information on participant rights which is relevant to all research studies, and improves comprehension of patients who typically participate in clinical trials.

  9. Spinal cord injury (SCI) rehabilitation: systematic analysis of communication from the biopsychosocial perspective.

    PubMed

    Hartley, Naomi A

    2015-07-02

    Communication is powerful predictor of health-related quality of life and overall well-being, yet its role in promoting rehabilitation outcomes in spinal cord injury (SCI) is rarely mentioned. This article systematically analyzes and synthesizes literature from multiple disciplines according to a biopsychosocial perspective, providing an evidence base for clinical practice and clear direction for future research. Systematic literature review and analysis, incorporating mapping to International Classification of Functioning, Disability and Health (ICF) codes. In total 4338 entries were retrieved from CINAHL, PsychInfo, Medline, PubMed and SpeechBite databases for the period 1990-2014. A total of 115 treatment and observational studies (quantitative and qualitative) detailed aspects of communication according to structure, function, activity, participation and environmental factors; evident of the complex interactions between communicative function with daily living after SCI. Communication is a relative strength in SCI, key to empowerment, independence, social interaction, and well-being, yet its potential to enhance SCI rehabilitation outcomes remains largely underexplored and untapped. Through elucidating interactions between communication and functioning, the adapted ICF framework affords clinicians and researchers insight into areas of intervention most likely to result in widespread gains. Conscious consideration should be given to the role of communication, within an integrative, strengths-based, multidisciplinary approach to clinical practice and future research. Implications for Rehabilitation Communication fosters empowerment, independence and greater participation in life roles; recognized as a powerful predictor of health-related quality of life and overall well-being. The ICF framework elucidates influences to communicative function, and components which are influenced by communication, providing valuable insight for clinicians and researchers. Therapeutic and research endeavors guided by existing ICF core sets are at risk of failing to consider communication, thereby limiting rehabilitation outcomes. Tapping the potential of communication as a relative strength within SCI rehabilitation holds considerable promise, within integrative, strengths-based, multidisciplinary approaches to clinical practice and future research.

  10. HIV/AIDS: use of the ICF in Brazil and South Africa--comparative data from four cross-sectional studies.

    PubMed

    Myezwa, H; Buchalla, C M; Jelsma, J; Stewart, A

    2011-03-01

    Human immunodeficiency virus (HIV) is a serious disease which can be associated with various activity limitations and participation restrictions. The aim of this paper was to describe how HIV affects the functioning and health of people within different environmental contexts, particularly with regard to access to medication. Four cross-sectional studies, three in South Africa and one in Brazil, had applied the International Classification of Functioning, Disability and Health (ICF) as a classification instrument to participants living with HIV. Each group was at a different stage of the disease. Only two groups had had continuing access to antiretroviral therapy. The existence of these descriptive sets enabled comparison of the disability experienced by people living with HIV at different stages of the disease and with differing access to antiretroviral therapy. Common problems experienced in all groups related to weight maintenance, with two-thirds of the sample reporting problems in this area. Mental functions presented the most problems in all groups, with sleep (50%, 92/185), energy and drive (45%, 83/185), and emotional functions (49%, 90/185) being the most affected. In those on long-term therapy, body image affected 93% (39/42) and was a major problem. The other groups reported pain as a problem, and those with limited access to treatment also reported mobility problems. Cardiopulmonary functions were affected in all groups. Functional problems occurred in the areas of impairment and activity limitation in people at advanced stages of HIV, and more limitations occurred in the area of participation for those on antiretroviral treatment. The ICF provided a useful framework within which to describe the functioning of those with HIV and the impact of the environment. Given the wide spectrum of problems found, consideration could be given to a number of ICF core sets that are relevant to the different stages of HIV disease. Copyright © 2010 Chartered Society of Physiotherapy. All rights reserved.

  11. Conversion of the Mini-Mental State Examination to the International Classification of Functioning, Disability and Health terminology and scoring system.

    PubMed

    De Vriendt, P; Gorus, E; Bautmans, I; Mets, T

    2012-01-01

    In older patients, evaluation of the cognitive status is crucial. The Mini-Mental State Examination (MMSE) is widely used for screening of cognition, providing fairly high sensitivity, specificity and reproducibility. Recently, a consensus emerged on the necessity of an international and transparent language, as provided by the WHO's International Classification of Functioning, Disability and Health (ICF). Most assessment tools however are not in accordance with the ICF. To reformulate the MMSE according to the ICF, both for the individual items and for the scoring system. MMSE data (scores varying from 3 to 30/30) of (1) 217 cognitively healthy elderly, (2) 60 persons with mild cognitive impairment, (3) 60 patients with mild Alzheimer's disease (AD), and (4) 60 patients with moderate/severe AD were obtained from studies at a university hospital setting. Subjects were aged 65 years or more and recruited either through advertisement (group 1), from the geriatric day hospital (groups 2 and 3), or the geriatric ward (group 4). The allocation to the groups was done after multidisciplinary evaluation. The conversion of the MMSE to ICF-MMSE was done by content comparison and by subsequent translation of the scoring system using automatic algorithms. All MMSE items were converted to the corresponding ICF categories. Three ICF domains were addressed: global and specific mental functions, general tasks and demands, divided over 6 ICF categories (orientation time/place, sustaining attention, memory functions, mental functions of language, undertaking a simple task). Scores on individual items were transformed according to their relative weight on the original MMSE scale, and a total ICF-MMSE score from 0 (no problem) to 100 (complete problem) was generated. Translation was satisfying, as illustrated by a good correlation between MMSE and ICF-MMSE. The diagnostic groups were distributed over the ICF-MMSE scores as expected. For each ICF domain, ICF-MMSE subscores were higher with increasing severity in cognitive decline. There was a higher dispersion, in accordance with the more detailed scoring possibilities of the ICF-MMSE. It is possible to adapt the MMSE to the ICF concept. This adaptation enhances interdisciplinary communication since it provides more clarity in assessment, with better visibility of the areas covered by the instrument. Copyright © 2011 S. Karger AG, Basel.

  12. Physiologic Systems and Their Responses to Conditions of Heat and Cold

    DTIC Science & Technology

    2012-01-01

    serial measures are made. Hypohydration increases heat storage by reducing sweating rate and skin blood-flow responses for a given core temperature. In...Capi’llary (3.5 L) E_xc_h~ (B%TBW) - - t Lymph Fluid Output I ) Urine Sweat ,JSF (1 1.5 L) (25% TBW) Osmotic Exchange ..._ _ ICF (30 L) (67%TBW...diuretics increase urine formation and generally result in the loss of boch solures and warer. Diuretic-induced hypohydrarion generally results in an

  13. Space Generic Open Avionics Architecture (SGOAA) standard specification

    NASA Technical Reports Server (NTRS)

    Wray, Richard B.; Stovall, John R.

    1993-01-01

    The purpose of this standard is to provide an umbrella set of requirements for applying the generic architecture interface model to the design of a specific avionics hardware/software system. This standard defines a generic set of system interface points to facilitate identification of critical interfaces and establishes the requirements for applying appropriate low level detailed implementation standards to those interface points. The generic core avionics system and processing architecture models provided herein are robustly tailorable to specific system applications and provide a platform upon which the interface model is to be applied.

  14. Content comparison of haemophilia specific patient-rated outcome measures with the international classification of functioning, disability and health (ICF, ICF-CY)

    PubMed Central

    2010-01-01

    Background Patient-Reported Outcomes (PROs) are considered important outcomes because they reflect the patient's experience in clinical trials. PROs have been included in the field of haemophilia only recently. Purpose Comparing the contents of PROs measures used in haemophilia, based on the ICF/ICF-CY as frame of reference. Methods Haemophilia-specific PROs for adults and children were selected on the grounds of international accessibility. The content of the selected instruments were examined by linking the concepts within the items of these instruments to the ICF/ICF-CY. Results Within the 5 selected instruments 365 concepts were identified, of which 283 concepts were linked to the ICF/ICF CY and mapped into 70 different categories. The most frequently used categories were "b152: Emotional functions" and "e1101: Drugs". Conclusions The present paper provides an overview on current PROs in haemophilia and facilitates the selection of appropriate instruments for specific purposes in clinical and research settings. This work was made possible by the grant of the European Murinet Project (Multidisciplinary Research Network on Health and Disability in Europe). PMID:21108796

  15. Participation as an outcome measure in psychosocial oncology: content of cancer-specific health-related quality of life instruments.

    PubMed

    van der Mei, Sijrike F; Dijkers, Marcel P J M; Heerkens, Yvonne F

    2011-12-01

    To examine to what extent the concept and the domains of participation as defined in the International Classification of Functioning, Disability and Health (ICF) are represented in general cancer-specific health-related quality of life (HRQOL) instruments. Using the ICF linking rules, two coders independently extracted the meaningful concepts of ten instruments and linked these to ICF codes. The proportion of concepts that could be linked to ICF codes ranged from 68 to 95%. Although all instruments contained concepts linked to Participation (Chapters d7-d9 of the classification of 'Activities and Participation'), the instruments covered only a small part of all available ICF codes. The proportion of ICF codes in the instruments that were participation related ranged from 3 to 35%. 'Major life areas' (d8) was the most frequently used Participation Chapter, with d850 'remunerative employment' as the most used ICF code. The number of participation-related ICF codes covered in the instruments is limited. General cancer-specific HRQOL instruments only assess social life of cancer patients to a limited degree. This study's information on the content of these instruments may guide researchers in selecting the appropriate instrument for a specific research purpose.

  16. To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England.

    PubMed

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2012-01-01

    The success of the International Classification of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and reflective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, field notes and a reflective diary. Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. The empirical findings demonstrate how to make the ICF classification a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians.

  17. A tool for enhancing strategic health planning: a modeled use of the International Classification of Functioning, Disability and Health

    PubMed Central

    Sinclair, Lisa Bundara; Fox, Michael H.; Betts, Donald R.

    2015-01-01

    SUMMARY This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan. This article is a US Government work and is in the public domain in the USA. PMID:23147247

  18. A tool for enhancing strategic health planning: a modeled use of the International Classification of Functioning, Disability and Health.

    PubMed

    Sinclair, Lisa Bundara; Fox, Michael H; Betts, Donald R

    2013-01-01

    This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan. Published 2012. This article is a US Government work and is in the public domain in the USA.

  19. Effect of Symmetry on Performance of Imploding Capsules using the Big Foot Design

    NASA Astrophysics Data System (ADS)

    Khan, Shahab; Casey, Daniel; Baker, Kevin; Thomas, Cliff; Nora, Ryan; Spears, Brian; Benedetti, Laura; Izumi, Nobuhiko; Ma, Tammy; Nagel, Sabrina; Pak, Arthur; National Ignition Facility Collaboration

    2017-10-01

    At the National Ignition Facility, several simultaneous designs are investigated for optimizing Inertial Confinement Fusion (ICF) energy gain of indirectly driven imploding fuel capsules. Relatively high neutron yield has been achieved while exhibiting a non-symmetric central core and/or shell. While developing the ``Big Foot'' design, several tuning steps were undertaken to minimize the asymmetry of both the central hot core as well as the shell. Surrogate capsules (symcaps) were utilized in the 2-D Radiography platform to assess both the shell and central core symmetry. The results of the tuning experiments are presented. In addition, a comparison of performance and shape metrics demonstrates that improving symmetry of the implosion can yield better performance. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344. LLNL-ABS-683471.

  20. Towards a standardized nutrition and dietetics terminology for clinical practice: An Austrian multicenter clinical documentation analysis based on the International Classification of Functioning, Disability and Health (ICF)-Dietetics.

    PubMed

    Gäbler, Gabriele; Coenen, Michaela; Lycett, Deborah; Stamm, Tanja

    2018-03-03

    High quality, continuity and safe interdisciplinary healthcare is essential. Nutrition and dietetics plays an important part within the interdisciplinary team in many health conditions. In order to work more effectively as an interdisciplinary team, a common terminology is needed. This study investigates which categories of the ICF-Dietetics are used in clinical dietetic care records in Austria and which are most relevant to shared language in different medical areas. A national multicenter retrospective study was conducted to collect clinical dietetic care documentation reports. The analysis included the "best fit" framework synthesis, and a mapping exercise using the ICF Linking Rules. Medical diagnosis and intervention concepts were excluded from the mapping, since they are not supposed to be classified by the ICF. From 100 dietetic records, 307 concepts from 1807 quotations were extracted. Of these, 241 assessment, dietetics diagnosis, goal setting and evaluation concepts were linked to 153 ICF-Dietetics categories. The majority (91.3%) could be mapped to a precise ICF-Dietetics category. The highest number of ICF-Dietetics categories was found in the medical area of diabetes and metabolism and belonged to the ICF component Body Function, while very few categories were used from the component Participation and Environmental Factors. The integration of the ICF-Dietetics in nutrition and dietetic care process is possible. Moreover, it could be considered as a conceptual framework for interdisciplinary nutrition and dietetics care. However, a successful implementation of the ICF-Dietetics in clinical practice requires a paradigm shift from medical diagnosis-focused health care to a holistic perspective of functioning with more attention on Participation and Environmental Factors. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  1. Linking of the quality of life in neurological disorders (Neuro-QoL) to the international classification of functioning, disability and health.

    PubMed

    Wong, Alex W K; Lau, Stephen C L; Cella, David; Lai, Jin-Shei; Xie, Guanli; Chen, Lidian; Chan, Chetwyn C H; Heinemann, Allen W

    2017-09-01

    The quality of life in neurological disorders (Neuro-QoL) is a U.S. National Institutes of Health initiative that produced a set of self-report measures of physical, mental, and social health experienced by adults or children who have a neurological condition or disorder. To describe the content of the Neuro-QoL at the item level using the World Health Organization's international classification of functioning, disability and health (ICF). We assessed the Neuro-QoL for its content coverage of functioning and disability relative to each of the four ICF domains (i.e., body functions, body structures, activities and participation, and environment). We used second-level ICF three-digit codes to classify items into categories within each ICF domain and computed the percentage of categories within each ICF domain that were represented in the Neuro-QoL items. All items of Neuro-QoL could be mapped to the ICF categories at the second-level classification codes. The activities and participation domain and the mental functions category of the body functions domain were the areas most often represented by Neuro-QoL. Neuro-QoL provides limited coverage of the environmental factors and body structure domains. Neuro-QoL measures map well to the ICF. The Neuro-QoL-ICF-mapped items provide a blueprint for users to select appropriate measures in ICF-based measurement applications.

  2. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL 4.0 Generic Core Scales.

    PubMed

    Varni, James W; Limbers, Christine A; Burwinkle, Tasha M

    2007-07-16

    Advances in biomedical science and technology have resulted in dramatic improvements in the healthcare of pediatric chronic conditions. With enhanced survival, health-related quality of life (HRQOL) issues have become more salient. The objectives of this study were to compare generic HRQOL across ten chronic disease clusters and 33 disease categories/severities from the perspectives of patients and parents. Comparisons were also benchmarked with healthy children data. The analyses were based on over 2,500 pediatric patients from 10 physician-diagnosed disease clusters and 33 disease categories/severities and over 9,500 healthy children utilizing the PedsQL 4.0 Generic Core Scales. Patients were recruited from general pediatric clinics, subspecialty clinics, and hospitals. Pediatric patients with diabetes, gastrointestinal conditions, cardiac conditions, asthma, obesity, end stage renal disease, psychiatric disorders, cancer, rheumatologic conditions, and cerebral palsy self-reported progressively more impaired overall HRQOL than healthy children, respectively, with medium to large effect sizes. Patients with cerebral palsy self-reported the most impaired HRQOL, while patients with diabetes self-reported the best HRQOL. Parent proxy-reports generally paralleled patient self-report, with several notable differences. The results demonstrate differential effects of pediatric chronic conditions on patient HRQOL across diseases clusters, categories, and severities utilizing the PedsQL 4.0 Generic Core Scales from the perspectives of pediatric patients and parents. The data contained within this study represents a larger and more diverse population of pediatric patients with chronic conditions than previously reported in the extant literature. The findings contribute important information on the differential effects of pediatric chronic conditions on generic HRQOL from the perspectives of children and parents utilizing the PedsQL 4.0 Generic Core Scales. These findings with the PedsQL have clinical implications for the healthcare services provided for children with chronic health conditions. Given the degree of reported impairment based on PedsQL scores across different pediatric chronic conditions, the need for more efficacious targeted treatments for those pediatric patients with more severely impaired HRQOL is clearly and urgently indicated.

  3. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales

    PubMed Central

    Varni, James W; Limbers, Christine A; Burwinkle, Tasha M

    2007-01-01

    Background Advances in biomedical science and technology have resulted in dramatic improvements in the healthcare of pediatric chronic conditions. With enhanced survival, health-related quality of life (HRQOL) issues have become more salient. The objectives of this study were to compare generic HRQOL across ten chronic disease clusters and 33 disease categories/severities from the perspectives of patients and parents. Comparisons were also benchmarked with healthy children data. Methods The analyses were based on over 2,500 pediatric patients from 10 physician-diagnosed disease clusters and 33 disease categories/severities and over 9,500 healthy children utilizing the PedsQL™ 4.0 Generic Core Scales. Patients were recruited from general pediatric clinics, subspecialty clinics, and hospitals. Results Pediatric patients with diabetes, gastrointestinal conditions, cardiac conditions, asthma, obesity, end stage renal disease, psychiatric disorders, cancer, rheumatologic conditions, and cerebral palsy self-reported progressively more impaired overall HRQOL than healthy children, respectively, with medium to large effect sizes. Patients with cerebral palsy self-reported the most impaired HRQOL, while patients with diabetes self-reported the best HRQOL. Parent proxy-reports generally paralleled patient self-report, with several notable differences. Conclusion The results demonstrate differential effects of pediatric chronic conditions on patient HRQOL across diseases clusters, categories, and severities utilizing the PedsQL™ 4.0 Generic Core Scales from the perspectives of pediatric patients and parents. The data contained within this study represents a larger and more diverse population of pediatric patients with chronic conditions than previously reported in the extant literature. The findings contribute important information on the differential effects of pediatric chronic conditions on generic HRQOL from the perspectives of children and parents utilizing the PedsQL™ 4.0 Generic Core Scales. These findings with the PedsQL™ have clinical implications for the healthcare services provided for children with chronic health conditions. Given the degree of reported impairment based on PedsQL™ scores across different pediatric chronic conditions, the need for more efficacious targeted treatments for those pediatric patients with more severely impaired HRQOL is clearly and urgently indicated. PMID:17634123

  4. Progress Toward Modeling Spectroscopic Signatures of Mix on Omega and NIF

    NASA Astrophysics Data System (ADS)

    Tregillis, I. L.; Schmitt, M. J.; Hsu, S. C.; Wysocki, F. J.; Cobble, J. A.; Murphy, T. J.

    2011-10-01

    Defect-induced mix processes may degrade the performance of ICF and ICF-like targets at Omega and NIF. An improved understanding of the relevant physics requires an experimental program built on a foundation of radiation-hydrodynamic simulations plus reliable synthetic diagnostic outputs. To that end, the Applications of Ignition (AoI) and Defect Implosion Experiment (DIME) efforts at LANL have focused on directly driven plastic capsules containing high-Z dopants and manufactured with an equatorial ``trench'' defect. One of the key diagnostic techniques for detecting and diagnosing the migration of dopant material into the hot core is Multi-Monochromatic X-ray Imaging (MMI). This talk will focus on recent efforts to model spectroscopic signatures of mix processes in AoI/DIME capsules via simulated MMI-type diagnostic instruments. It will also include data from recent Omega shots and calculations in support of Tier 1 experiments at NIF in FY2012. This work is supported by US DOE/NNSA, performed at LANL, operated by LANS LLC under contract DE-AC52-06NA25396.

  5. Spirituality and the International Classification of Functioning, Disability and Health: content comparison of questionnaires measuring mindfulness based on the International Classification of Functioning.

    PubMed

    Offenbächer, Martin; Sauer, Sebastian; Hieblinger, Robin; Hufford, David J; Walach, Harald; Kohls, Niko

    2011-01-01

    To identify and compare the concepts contained in questionnaires measuring mindfulness using the International Classification of Functioning (ICF) as external reference. Questionnaires which are published in peer-reviewed journals and listed in Pubmed or PsycInfo were included. The questionnaires were analysed and, using a content-analytical approach, the respective items were categorised and linked to the ICF. Ten questionnaires were included. Ninety-four per cent (N = 341) of the concepts could be linked to 37 different ICF categories. One hundred and seventy-one (50.1%) concepts were linked to ICF categories of the component Body Function, 74 (21.7%) to categories of the component Activity and Participation and none to categories of the component Environmental Factors. In total, 28.2% of the linked concepts belonged to Personal factors, which are not yet classified in the ICF. The questionnaires exhibited considerable differences regarding content density (i.e. the average number of concepts per item) and content diversity (i.e. the number of ICF categories per concept). The ICF provides an useful external reference to identify and compare the concepts contained in mindfulness questionnaires. Also, mindfulness questionnaire concepts suggest potentially useful factors for classification within the ICF.

  6. Clinical application of ICF key codes to evaluate patients with dysphagia following stroke

    PubMed Central

    Dong, Yi; Zhang, Chang-Jie; Shi, Jie; Deng, Jinggui; Lan, Chun-Na

    2016-01-01

    Abstract This study was aimed to identify and evaluate the International Classification of Functioning (ICF) key codes for dysphagia in stroke patients. Thirty patients with dysphagia after stroke were enrolled in our study. To evaluate the ICF dysphagia scale, 6 scales were used as comparisons, namely the Barthel Index (BI), Repetitive Saliva Swallowing Test (RSST), Kubota Water Swallowing Test (KWST), Frenchay Dysarthria Assessment, Mini-Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). Multiple regression analysis was performed to quantitate the relationship between the ICF scale and the other 7 scales. In addition, 60 ICF scales were analyzed by the least absolute shrinkage and selection operator (LASSO) method. A total of 21 ICF codes were identified, which were closely related with the other scales. These included 13 codes from Body Function, 1 from Body Structure, 3 from Activities and Participation, and 4 from Environmental Factors. A topographic network map with 30 ICF key codes was also generated to visualize their relationships. The number of ICF codes identified is in line with other well-established evaluation methods. The network topographic map generated here could be used as an instruction tool in future evaluations. We also found that attention functions and biting were critical codes of these scales, and could be used as treatment targets. PMID:27661012

  7. International Classification of Functioning, Disability and Health: Catalyst for interprofessional education and collaborative practice.

    PubMed

    Snyman, Stefanus; Von Pressentin, Klaus B; Clarke, Marina

    2015-01-01

    Patient-centred and community-based care is required for promotion of health equity. To enhance patient-centred interprofessional care, the World Health Organization recommends using the framework of the International Classification of Functioning, Disability and Health (ICF). Stellenbosch University's Interprofessional Education and Collaborative Practice (IPECP) strategy has promoted using ICF since 2010. Undergraduate medical students on rural clinical placements are expected to use ICF in approaching and managing patients. Students' ability to develop interprofessional care plans using ICF is assessed by a team of preceptors representing various health professions. This study explored the experiences of medical students and their preceptors using ICF in IPECP, and how patients perceived care received. Associative Group Analysis methodology was used to collect data for this study. In total, 68 study participants were enrolled of which 37 were medical students, 16 preceptors and 15 patients. Students found ICF enabled a patient-centred approach and reinforce the importance of context. Patients felt listened to and cared for. Preceptors, obliged to use ICF, came to appreciate the advantages of interprofessional care, promoting mutually beneficial teamwork and job satisfaction. The value of integrating IPECP as an authentic learning experience was demonstrated as was ICF as a catalyst in pushing boundaries for change.

  8. To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England

    PubMed Central

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2012-01-01

    Purpose: The success of the International Classifcation of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Method: Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and refective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, feld notes and a refective diary. Results: Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. Conclusions: The empirical fndings demonstrate how to make the ICF classifcation a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians. PMID:22372376

  9. Space Generic Open Avionics Architecture (SGOAA) reference model technical guide

    NASA Technical Reports Server (NTRS)

    Wray, Richard B.; Stovall, John R.

    1993-01-01

    This report presents a full description of the Space Generic Open Avionics Architecture (SGOAA). The SGOAA consists of a generic system architecture for the entities in spacecraft avionics, a generic processing architecture, and a six class model of interfaces in a hardware/software system. The purpose of the SGOAA is to provide an umbrella set of requirements for applying the generic architecture interface model to the design of specific avionics hardware/software systems. The SGOAA defines a generic set of system interface points to facilitate identification of critical interfaces and establishes the requirements for applying appropriate low level detailed implementation standards to those interface points. The generic core avionics system and processing architecture models provided herein are robustly tailorable to specific system applications and provide a platform upon which the interface model is to be applied.

  10. Characterization of inertial confinement fusion (ICF) targets using PIXE, RBS, and STIM analysis.

    PubMed

    Li, Yongqiang; Liu, Xue; Li, Xinyi; Liu, Yiyang; Zheng, Yi; Wang, Min; Shen, Hao

    2013-08-01

    Quality control of the inertial confinement fusion (ICF) target in the laser fusion program is vital to ensure that energy deposition from the lasers results in uniform compression and minimization of Rayleigh-Taylor instabilities. The technique of nuclear microscopy with ion beam analysis is a powerful method to provide characterization of ICF targets. Distribution of elements, depth profile, and density image of ICF targets can be identified by particle-induced X-ray emission, Rutherford backscattering spectrometry, and scanning transmission ion microscopy. We present examples of ICF target characterization by nuclear microscopy at Fudan University in order to demonstrate their potential impact in assessing target fabrication processes.

  11. The Health and Functioning ICF-60: Development and Psychometric Properties

    PubMed Central

    Tutelyan, V A; Chatterji, S; Baturin, A K; Pogozheva, A V; Kishko, O N; Akolzina, S E

    2014-01-01

    Background This paper describes the development and psychometric properties of the Health and Functioning ICF-60 (HF-ICF-60) measure, based on the World Health Organization (WHO) ‘International Classification of Functioning, Disability and Health: ICF’ (2001). The aims of the present study were to test psychometric properties of the HF-ICF-60, developed as a measure that would be responsive to change in functioning through changes in health and nutritional status, as a prospective measure to monitor health and nutritional status of populations and to explore the relationship of the HF-ICF-60 with quality of life measures such as the World Health Organization WHOQOL-BREF quality of life assessment in relation to non-communicable diseases. Methods The HF-ICF-60 measure consists of 60 items selected from the ICF by an expert panel, which included 18 items that cover Body Functions, 21 items that cover Activities and Participation, rated on five-point scales, and 21 items that cover Environmental Factors (seven items cover Individual Environmental Factors and 14 items cover Societal Environmental Factors), rated on nine-point scales. The HF-ICF-60 measure was administered to the Russian nationally representative sample within the Russian National Population Quality of Life, Health and Nutrition Survey, in 2004 (n = 9807) and 2005 (n = 9560), as part of the two waves of the Russian Longitudinal Monitoring Survey (RLMS). The statistical analyses were carried out with the use of both classical and modern psychometric methods, such as factor analysis, and based on Item Response Theory, respectively. Results The HF-ICF-60 questionnaire is a new measure derived directly from the ICF and covers the ICF components as follows: Body Functions, Activities and Participation, and Environmental Factors (Individual Environmental Factors and Societal Environmental Factors). The results from the factor analyses (both Exploratory Factor Analyses and Confirmatory Factor Analyses) show good support for the proposed structure together with an overall higher-order factor for each scale of the measure. The measure has good reliability and validity, and sensitivity to change in the health and nutritional status of respondents over time. Normative values were developed for the Russian adult population. Conclusions The HF-ICF-60 has shown good psychometric properties in the two waves of the nationally representative RLMS, which provided considerable support to using the HF-ICF-60 data as the normative health and functioning values for the Russian population. Similarly, the administration of the WHOQOL-BREF in the same two waves of the nationally representative RLMS has allowed the normative quality of life values for the Russian population to be obtained. Therefore, the objective assessment of health and functioning of the HF-ICF-60 could be mapped onto the subjective evaluation of quality of life of the WHOQOL-BREF to increase the potential usefulness of the surveys in relation to non-communicable diseases. © 2014 The Authors. Clinical Psychology & Psychotherapy. Published by John Wiley & Sons, Ltd. Key Practitioner Message The HF-ICF-60 offers a new perspective in measuring change in functioning through changes in lifestyle and diet. The HF-ICF-60 can be combined with the WHOQOL-BREF to map the objective assessment of health and functioning onto the subjective evaluation of quality of life. Combined use of the HF-ICF-60 and the WHOQOL-BREF can be especially useful for national and global monitoring and surveillance of implementation of measures to reduce risk factors of non-communicable diseases and to promote healthy lifestyles and healthy diets. PMID:24931300

  12. Vesicourethral reflux-induced renal failure in a patient with ICF syndrome due to a novel DNMT3B mutation.

    PubMed

    Kutluğ, Seyhan; Ogur, Gönül; Yilmaz, Aysegül; Thijssen, Peter E; Abur, Ummet; Yildiran, Alisan

    2016-12-01

    ICF syndrome is a primary immunodeficiency disease characterized by hypo- or agammaglobulinemia, centromeric instability mainly on chromosomes 1, 9, and 16 and facial anomalies. ICF syndrome presents with frequent respiratory tract infections in infancy. A 20-month-old female patient was referred to our clinic due to frequent lower respiratory tract infections. ICF syndrome was considered because of comorbidity of hypogammaglobulinemia, facial anomalies, and neuromotor growth retardation. Metaphase chromosome analysis revealed centromeric instability on chromosomes 1, 9, and 16 and through Sanger a previously unreported homozygous missense mutation (c.1805T>C; [p.V602A]) was identified in the DNMT3B, confirming ICF1. The patient was found to have a breakdown in renal function 1 year later; the urinary system was examined and bilateral vesicoureteral reflux was found, warranting the need for dialysis in time. This report expands the mutation spectrum of ICF1 and is the first to describe bilateral vesicoureteral reflux accompanying ICF syndrome. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Laser targets compensate for limitations in inertial confinement fusion drivers

    NASA Astrophysics Data System (ADS)

    Kilkenny, J. D.; Alexander, N. B.; Nikroo, A.; Steinman, D. A.; Nobile, A.; Bernat, T.; Cook, R.; Letts, S.; Takagi, M.; Harding, D.

    2005-10-01

    Success in inertial confinement fusion (ICF) requires sophisticated, characterized targets. The increasing fidelity of three-dimensional (3D), radiation hydrodynamic computer codes has made it possible to design targets for ICF which can compensate for limitations in the existing single shot laser and Z pinch ICF drivers. Developments in ICF target fabrication technology allow more esoteric target designs to be fabricated. At present, requirements require new deterministic nano-material fabrication on micro scale.

  14. Engaging with clinicians to implement and evaluate the ICF in neurorehabilitation practice.

    PubMed

    Tempest, Stephanie; Jefferson, Richard

    2015-01-01

    Although deemed a globally accepted framework, there remains scare evidence on the process and outcome of implementing the International Classification of Functioning, Disability and Health (ICF) within neurorehabilitation. This review briefly explores the existing, broader literature and then reports on two action research projects, undertaken in England, specifically within stroke and neurorehabilitation. Working with participants, including clinicians from in-patient and community settings, there are now 35 different ways identified for the use of the ICF. The outcome of the first project highlights that using the ICF enhances communication within and beyond the acute stroke service, fosters holistic thinking and clarifies team roles. To adopt it into clinical practice, the ICF must be adapted to meet local service needs. The use of action research has facilitated the knowledge translation process which has enabled the ICF to become a clinical reality in neurorehabilitation, with clinicians identifying a range of potential uses.

  15. Reliability and validity of the PedsQL™ Generic Core Scales 4.0 for Chinese children with epilepsy.

    PubMed

    Duan, Xiaoling; Zhang, Shuqing; Xiao, Nong

    2012-04-01

    This investigation examines the reliability and validity of the Chinese version of the PedsQL 4.0 Generic Core Scales for prognostic measures of pediatric epilepsy. The study comprised 163 parents whose children, between the ages of 2 and 18 years, were diagnosed with epilepsy. The parents were given a questionnaire to be completed on behalf of the child. Reliability was assessed by Cronbach's alpha analysis. Validity was assessed by the exploratory factor analysis and intercorrelation analysis between the four subscales as well as Student's t-test. The internal consistency reliability for Total Scale Score was 0.94 by Cronbach's alpha test. Four major factors were extracted by factor analysis. The scores from all sub-scales derived from healthy children were significantly higher than children with epilepsy (P<0.001). The reliability and validity of the parent proxy-report scales from the Chinese version of the PedsQL™ 4.0 Generic Core Scales effectively matched the original version and could be used to evaluate the health-related quality of life of children with epilepsy. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Outcome Measurement in the Treatment of Spasmodic Dysphonia: A Systematic Review of the Literature.

    PubMed

    Rumbach, Anna; Aiken, Patrick; Novakovic, Daniel

    2018-04-11

    The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  17. Detection and use of HT and DT gamma rays to diagnose mix in ICF capsules

    NASA Astrophysics Data System (ADS)

    Schmitt, M. J.; Kim, Y. H.; Herrmann, H. W.; McEvoy, A. M.; Zylstra, A.; Leatherland, A.; Gales, S.

    2015-11-01

    Recent results from Omega capsule implosion experiments containing HT-rich gas mixtures indicate that the 19.8 MeV gamma ray from aneutronic HT fusion can be measured using existing time-resolved gas Cherenkov detectors (GCDs). Additional dedicated experiments to characterize HT- γ emission in ICF experiments already have been planned. The concurrent temporally-resolved measurement of both HT- γs and DT- γs opens the door for in-depth exploration of interface mix in gas-filled ICF capsules. We propose a method to temporally resolve and observe the evolution of shell material into the capsule core as a function of fuel/shell interface temperature (which can be varied by varying the capsule shell thickness). Our proposed method uses a CD-lined plastic capsule filled with 50/50 HT gas and diagnosed using GCDs to temporally resolve both the HT ``clean'' and DT ``mix'' gamma ray burn histories. It will be shown that these burn history profiles are sensitive to the depth to which shell material mixes into the gas region. An experiment to observe these differences as a function of capsule shell thickness is proposed to determine if interface mixing is consistent with thermal diffusion (λion ~Tion2 /Zion2 ρ) at the gas/shell interface. Since hydrodynamic mixing from shell perturbations, such as the mounting stalk and glue, could complicate these types of capsule-averaged temporal measurements, simulations including their effects also will be shown. This research supported by the US DOE/NNSA, performed in part at LANL, operated by LANS LLC under contract DE-AC52-06NA25396.

  18. Perspectives on Teaching the International Classification of Functioning, Disability, and Health Model to Physical Therapy Students.

    PubMed

    Peters-Brinkerhoff, Cheryl

    2016-01-01

    During a reaccreditation visit, deficiencies were discovered in the clinical education curriculum regarding patient-centered care in a Doctorate of Physical Therapy program. To understand the problem and address those deficiencies, the clinical internship experience was examined using the International Classification of Functioning, Disability, and Health (ICF) model as a conceptual framework for clinical reasoning. This qualitative case study aimed to study (1) perceptions of physical therapy (PT) students regarding their knowledge and learning experiences during clinical affiliations and what knowledge they acquired of the ICF as applied to patient-centered care during their internship, and (2) the perceptions of clinical instructors (CIs) of their knowledge of the ICF model, its integration into their practice, barriers to its use, and the learning experiences the CIs provided to students regarding the ICF model. Data were collected using questionnaires sent to 42 CIs and at focus groups of 22 PT students conducted at the study site. Data were also collected from student evaluations on the Clinical Performance Instrument. Data were analyzed using coding techniques and themes based on the use of the ICF model in the clinical setting by students and CIs. Most CIs reported a poor understanding of the ICF model or how it relates to patient-centered care; both CIs and students reported none to minimal learning experience related to the ICF model. Document analysis of the student evaluations revealed no assessment of the ICF model was mentioned. Learning experiences of all domains of the ICF model are generally not being presented to PT students during their clinical affiliations.

  19. [Evaluation and improvement of the comprehension of informed consent documents].

    PubMed

    López-Picazo Ferrer, Julio José; Tomás Garcia, Nuria

    2016-04-01

    The information contained in a good informed consent form (ICF) must be understood by the patients. The aim of this study is to assess and improve the readability of the ICF submitted for accreditation in a tertiary hospital. Study of assessment and improvement of the quality of 132 ICF from 2 departments of a public tertiary hospital, divided into 3 phases: Initial assessment, intervention and reassessment. Both length and readability are assessed. Length is measured in words (adequate to 470, excessive over 940), and readability in INFLESZ points (suitable if over 55). The ICF contents initially proposed by departments were adapted by non-health-related trained persons, whose doubts about medical terms were resolved by the authors. To compare results between evaluations, relative improvement (in both length and INFLESZ) and statistical significances were calculated. 78.8% of the ICFs showed a desired length (CI95% 86,5-71,1) and a mean of 44.1 INFLESZ points (3.8% >55 points, CI95% 6,0-1,6). After the intervention, INFLESZ raised to 61.9 points (improvement 40.3%, P<.001), all ICF showing >55 points. The resulting ICFs had a longer description of the nature of the procedure (P<.0001) and a shorter description of their consequences, risks (P <.0001) and alternatives (P <.05). The introduction of improvement dynamics in the design of ICFs is possible and necessary because it produces more effective and easily readable ICFs. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Portugal's special education law: implementing the International Classification of Functioning, Disability and Health in policy and practice.

    PubMed

    Sanches-Ferreira, Manuela; Simeonsson, Rune J; Silveira-Maia, Mónica; Alves, Sílvia; Tavares, Ana; Pinheiro, Sara

    2013-05-01

    The International Classification of Functioning, Disability and Health (ICF) was introduced in Portuguese education law as the compulsory system to guide eligibility policy and practice in special education. This paper describes the implementation of the ICF and its utility in the assessment process and eligibility determination of students for special education. A study to evaluate the utility of the ICF was commissioned by the Portuguese Ministry of Education and carried out by an external evaluation team. A document analysis was made of the assessment and eligibility processes of 237 students, selected from a nationally representative sample. The results provided support for the use of the ICF in student assessment and in the multidimensional approach of generating student functioning profiles as the basis for determining eligibility. The use of the ICF contributed to the differentiation of eligible and non eligible students based on their functioning profiles. The findings demonstrate the applicability of the ICF framework and classification system for determining eligibility for special education services on the basis of student functioning rather than medical or psychological diagnose. The use of the International Classification of Functioning, Disability and Health (ICF) framework in special education policy is as follows: • The functional perspective of the ICF offers a more comprehensive, holistic assessment of student needs than medical diagnoses. • ICF-based assessment of the nature and severity of functioning can serve as the basis for determining eligibility for special education and habilitation. • Profiles of functioning can support decision making in designing appropriate educational interventions for students.

  1. Application of the International Classification of Functioning, Disability and Health (ICF) to people with dysphagia following non-surgical head and neck cancer management.

    PubMed

    Nund, Rebecca L; Scarinci, Nerina A; Cartmill, Bena; Ward, Elizabeth C; Kuipers, Pim; Porceddu, Sandro V

    2014-12-01

    The International Classification of Functioning, Disability, and Health (ICF) is an internationally recognized framework which allows its user to describe the consequences of a health condition on an individual in the context of their environment. With growing recognition that dysphagia can have broad ranging physical and psychosocial impacts, the aim of this paper was to identify the ICF domains and categories that describe the full functional impact of dysphagia following non-surgical head and neck cancer (HNC) management, from the perspective of the person with dysphagia. A secondary analysis was conducted on previously published qualitative study data which explored the lived experiences of dysphagia of 24 individuals with self-reported swallowing difficulties following HNC management. Categories and sub-categories identified by the qualitative analysis were subsequently mapped to the ICF using the established linking rules to develop a set of ICF codes relevant to the impact of dysphagia following HNC management. The 69 categories and sub-categories that had emerged from the qualitative analysis were successfully linked to 52 ICF codes. The distribution of these codes across the ICF framework revealed that the components of Body Functions, Activities and Participation, and Environmental Factors were almost equally represented. The findings confirm that the ICF is a valuable framework for representing the complexity and multifaceted impact of dysphagia following HNC. This list of ICF codes, which reflect the diverse impact of dysphagia associated with HNC on the individual, can be used to guide more holistic assessment and management for this population.

  2. Oral health of 65-year olds in Sweden and Norway: a global question and ICF, the latest conceptual model from WHO.

    PubMed

    Ekbäck, Gunnar; Åstrøm, Anne Nordrehaug; Klock, Kristin; Ordell, Sven; Unell, Lennart

    2012-07-01

    The aims of this study were to identify explanatory factors of satisfaction with oral health among Norwegian and Swedish 65 year olds in terms of items from four different domains of ICF and to compare the strengths of the various ICF domains in explaining satisfaction with oral health. Further it was to assess whether the explanatory factors of ICF domains vary between Norway and Sweden. In 2007, standardized questionnaires were mailed to all the residents in certain counties of Sweden and Norway who were born in 1942. Response rates were 73.1% (n = 6078) in Sweden and 56.0% (n = 4062) in Norway. In total, 33 questions based on four different ICF domains were chosen to explain satisfaction with oral health. Logistic regression showed that four different ICF domains in terms of body function, body structure, activity/participation and environmental factors explained, respectively, 53%, 31%, 12% and 34% of the explanatory variance in the satisfaction with oral health. In the final analysis, only nine items were statistically significant (p < 0.05). This study indicates that ICF as a conceptual model could cover a broad spectrum of factors embedded in OHRQoL measured by a global question in Sweden and Norway. Nine items, representing four ICF domains, were important in the final model for explaining satisfaction with oral health.

  3. A Booklet on Participants’ Rights to Improve Consent for Clinical Research: A Randomized Trial

    PubMed Central

    Benatar, Jocelyne R.; Mortimer, John; Stretton, Matthew; Stewart, Ralph A. H.

    2012-01-01

    Objective Information on the rights of subjects in clinical trials has become increasingly complex and difficult to understand. This study evaluates whether a simple booklet which is relevant to all research studies improves the understanding of rights needed for subjects to provide informed consent. Methods 21 currently used informed consent forms (ICF) from international clinical trials were separated into information related to the specific research study, and general information on participants’ rights. A booklet designed to provide information on participants’ rights which used simple language was developed to replace this information in current ICF’s Readability of each component of ICF’s and the booklet was then assessed using the Flesch-Kincaid Reading ease score (FK). To further evaluate the booklet 282 hospital inpatients were randomised to one of three ways to present research information; a standard ICF, the booklet combined with a short ICF, or the booklet combined with a simplified ICF. Comprehension of information related to the research proposal and to participant’s rights was assessed by questionnaire. Results Information related to participants’ rights contributed an average of 44% of the words in standard ICFs, and was harder to read than information describing the clinical trial (FK 25 versus (vs.) 41 respectively, p = 0.0003). The booklet reduced the number of words and improved FK from 25 to 42. The simplified ICF had a slightly higher FK score than the standard ICF (50 vs. 42). Comprehension assessed in inpatients was better for the booklet and short ICF 62%, (95% confidence interval (CI) 56 to 67) correct, or simplified ICF 62% (CI 58 to 68) correct compared to 52%, (CI 47 to 57) correct for the standard ICF, p = 0.009. This was due to better understanding of questions on rights (62% vs. 49% correct, p = 0.0008). Comprehension of study related information was similar for the simplified and standard ICF (60% vs. 64% correct, p = 0.68). Conclusions A booklet provides a simple consistent approach to providing information on participant rights which is relevant to all research studies, and improves comprehension of patients who typically participate in clinical trials. PMID:23094034

  4. Comparison of isometric cervical flexor and isometric cervical extensor system exercises on patients with neuromuscular imbalance and cervical crossed syndrome associated forward head posture.

    PubMed

    Lee, Jaejin; Kim, Dohyeon; Yu, Kyunghoon; Cho, Youngki; You, Joshua H

    2018-01-01

    Isometric cervical flexor system exercise (ICF) and isometric cervical extensor system exercise (ICE) are cervical stabilization techniques that have been used to restore cervical crossed syndrome (CCS)-associated forward head posture. However, the therapeutic effects and underlying motor control mechanisms remain elusive. The purpose of present study was investigating the concurrent therapeutic effects of ICF and ICE on muscle size, muscle imbalance ratio, and muscle recruitment sequence using ultrasound imaging and electromyography. A total of 18 participants (7 females; age=24±4.0 years) with CCS associated with forward head posture underwent ICF and ICE. Paired t-test analysis was used for statistical analysis. Paired t-test analysis showed that sternocleidomastoid thickness was greater during ICF than ICE. Similarly, cross-sectional area and horizontal thickness of the longus colli were greater during ICE than ICF. The upper trapezius/lower trapezius muscle imbalance ratio and the pectoralis major/lower trapezius muscle imbalance ratio were significantly decreased during the application of ICE compared to ICF. These results provide compelling, mechanistic evidence as to how ICE is more beneficial for the restoration of neuromuscular imbalance than ICF in individuals with CCS.

  5. Looking at the ICF and human communication through the lens of classification theory.

    PubMed

    Walsh, Regina

    2011-08-01

    This paper explores the insights that classification theory can provide about the application of the International Classification of Functioning, Disability and Health (ICF) to communication. It first considers the relationship between conceptual models and classification systems, highlighting that classification systems in speech-language pathology (SLP) have not historically been based on conceptual models of human communication. It then overviews the key concepts and criteria of classification theory. Applying classification theory to the ICF and communication raises a number of issues, some previously highlighted through clinical application. Six focus questions from classification theory are used to explore these issues, and to propose the creation of an ICF-related conceptual model of communicating for the field of communication disability, which would address some of the issues raised. Developing a conceptual model of communication for SLP purposes closely articulated with the ICF would foster productive intra-professional discourse, while at the same time allow the profession to continue to use the ICF for purposes in inter-disciplinary discourse. The paper concludes by suggesting the insights of classification theory can assist professionals to apply the ICF to communication with the necessary rigour, and to work further in developing a conceptual model of human communication.

  6. ICF-Based Analysis of Communication Disorders in Dementia of Alzheimer's Type

    PubMed Central

    Badarunisa, Mohamad Basheer; Sebastian, Daly; Rangasayee, Raghunath Rao; Kala, Baby

    2015-01-01

    Purpose Dementia of Alzheimer's type (DAT) is a major cognitive communication disorder. The present study attempted to analyse communication disorders in DAT in the International Classification of Functions (ICF) framework. The study investigated the impact of the severity of communication disorders in persons with DAT on activity participation and environment components of the ICF. Method Thirty bilingual individuals with DAT in the age range of 65-88 years were classified into three groups of mild, moderate and severe degree of dementia. Forty-three items of the American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS) were linked to the ICF framework. A few additional items were also added for a complete profiling of DAT. A total of 50 (ASHA FACS + ICF) items were rated and administered for the purpose of the study. Results The study revealed a disproportionate impact of the severity of DAT on activity participation and environment components of the ICF. Conclusion The present study investigated the utility of the ICF framework for profiling the functionality of persons with DAT. This profiling highlighted the need for ensuring effective communication and quality of life in the DAT population. PMID:26955380

  7. Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England

    PubMed Central

    Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2013-01-01

    Purpose: Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Method: Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Results: Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. Conclusions: The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. Implications for Rehabilitation The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. Using the ICF also challenged clinicians to think holistically about patient needs following a stroke. PMID:23530624

  8. Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England.

    PubMed

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2013-01-01

    Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. Using the ICF also challenged clinicians to think holistically about patient needs following a stroke.

  9. International classification of functioning, disability and health categories for spinal cord injury nursing in China.

    PubMed

    Li, Kun; Yan, Tiebin; You, Liming; Li, Rui; Ross, Amy Miner

    2015-01-01

    To explore a set of International Classification of Functioning, Disability and Health (ICF) categories that cover the spinal cord injury (SCI) nursing practice in China through a national expert survey. An internet-based email survey was used. An original set of ICF categories specifically for SCI nursing has been developed from the preliminary studies based on an international perspective. For cultural adaptation in China, a national expert survey was conducted with Chinese experts on SCI nursing to identify the ICF categories that were specifically for SCI nursing in China. The ICF categories which received more than 80% support from the experts would be reported. Twenty-nine Chinese experts on SCI nursing participated. There were 81 ICF categories which received more than 80% agreement among the experts, including 33 Body Functions categories, eight Body Structures, 24 Activities and Participation, six Environmental Factors and 10 Personal Factors items. A set of ICF categories that cover the SCI nursing practice in China was identified. It reflects the main issues that Chinese nurses focus on in caring SCI patients. These categories can facilitate Chinese nurses to use the ICF in multidisciplinary teamwork and improve the participation of nurses in the team. Implications for Rehabilitation In China, nurses lack of an effective model or tool to communicate with the other health professionals in the rehabilitation team for spinal cord injury (SCI) patients. International Classification of Functioning, Disability and Health (ICF) is a tool for multidisciplinary use, which can promote the communication and collaboration in the healthcare team by establishing a common language across different disciplines and sectors. This set of ICF categories developed from this study can serve as a roadmap for important items for use in clinical practice of Chinese SCI nursing.

  10. The holistic claims of the biopsychosocial conception of WHO's International Classification of Functioning, Disability, and Health (ICF): a conceptual analysis on the basis of a pluralistic-holistic ontology and multidimensional view of the human being.

    PubMed

    Solli, Hans Magnus; da Silva, António Barbosa

    2012-06-01

    The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF's claim to holism. The following components of the ICF's complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to be holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic-holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b).

  11. ICF Annual Report 1997

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Correll, D

    The continuing objective of Lawrence Livermore National Laboratory's (LLNL's) Inertial Confinement Fusion (ICF) Program is the demonstration of thermonuclear fusion ignition and energy gain in the laboratory and to support the nuclear weapons program in its use of ICF facilities. The underlying theme of all ICF activities as a science research and development program is the Department of Energy's (DOE's) Defense Programs (DP) science-based Stockpile Stewardship Program (SSP). The mission of the US Inertial Fusion Program is twofold: (1) to address high-energy-density physics issues for the SSP and (2) to develop a laboratory microfusion capability for defense and energy applications.more » In pursuit of this mission, the ICF Program has developed a state-of-the-art capability to investigate high-energy-density physics in the laboratory. The near-term goals pursued by the ICF Program in support of its mission are demonstrating fusion ignition in the laboratory and expanding the Program's capabilities in high-energy-density science. The National Ignition Facility (NIF) project is a cornerstone of this effort.« less

  12. Factors associated with expenditures for medicaid home and community based services (HCBS) and intermediate care facilities for persons with mental retardation (ICF/MR) services for persons with intellectual and developmental disabilities.

    PubMed

    Lakin, K Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger J; Taub, Sarah; Chiri, Giuseppina

    2008-06-01

    This article examines expenditures for a random sample of 1,421 adult Home and Community Based Services (HCBS) and Intermediate Care Facility/Mental Retardation (ICF/MR) recipients in 4 states. The article documents variations in expenditures for individuals with different characteristics and service needs and, controlling for individual characteristics, by residential setting type, Medicaid program (ICF/MR or HCBS), and state. Annual average per-person Medicaid expenditures for HCBS recipients were less than those of ICF/MR residents ($61,770 and $128,275, respectively). HCBS recipients had less severe disability (intellectual, physical, health service needs) than ICF/MR residents. Controlling these differences, and for congregate settings, HCBS were less costly than ICFs/MR, but this distinction accounted for only 3.3% of variation in expenditures. Persons living with families receiving HCBS ($25,072) and in host families (including foster, companion, or shared living arrangements; $44,112) had the lowest Medicaid expenditures.

  13. [¹²³I]ICF01012 melanoma imaging and [¹³¹I]ICF01012 dosimetry allow adapted internal targeted radiotherapy in preclinical melanoma models.

    PubMed

    Viallard, Claire; Perrot, Yann; Boudhraa, Zied; Jouberton, Elodie; Miot-Noirault, Elisabeth; Bonnet, Mathilde; Besse, Sophie; Mishellany, Florence; Cayre, Anne; Maigne, Lydia; Rbah-Vidal, Latifa; D'Incan, Michel; Cachin, Florent; Chezal, Jean-Michel; Degoul, Françoise

    2015-01-01

    Melanin-targeting radiotracers are interesting tools for imaging and treatment of pigmented melanoma metastases. However, variation of the pigment concentration may alter the efficiency of such targeting. A clear assessment of both tumor melanin status and dosimetry are therefore prerequisites for internal radiotherapy of disseminated melanoma. The melanin tracer ICF01012 was labelled with iodine-123 for melanoma imaging in pigmented murine B16F0 and human SK-Mel 3 melanomas. In vivo imaging showed that the uptake of [(123)I]ICF01012 to melanomas correlated significantly with melanin content. Schedule treatment of 3 × 25 MBq [(131)I]ICF01012 significantly reduced SK-Mel 3 tumor growth and significantly increased the median survival in treated mice. For this protocol, the calculated delivered dose was 53.2 Gy. Radio-iodinated ICF01012 is a good candidate for both imaging and therapeutic purposes for patients with metastatic pigmented melanomas.

  14. Consequences of rheumatoid arthritis for performance of social roles--a literature review.

    PubMed

    Geuskens, Goedele A; Burdorf, Alex; Hazes, Johanna M W

    2007-06-01

    To obtain quantitative estimates of restrictions in participation, i.e., the performance of social roles, in patients with rheumatoid arthritis (RA). Participation categories were selected from the International Classification of Functioning, Disability and Health (ICF) (preliminary) Comprehensive Core Set for RA. A literature search was performed utilizing PubMed and PsychInfo. Articles were included if: (1) performance in at least one of the participation categories was described; (2) patients with RA were compared to a healthy reference population or their performance over time was described; (3) published between 1995 and 2005; and (4) written in English. Seven participation categories were selected from the Comprehensive Core Set for RA, resulting in 50 articles included in the review. Almost all studies focused on remunerative employment (n = 30), recreation and leisure (n = 17), or both (n = 3). RA patients had an increased risk of being without a paid job compared to well adjusted reference groups (absolute difference 4% to 28%, odds ratios 1.2 to 3.4). Restrictions in employment occurred already within the early phase of RA and varied greatly among studies. Two years after diagnosis, disability benefits increased up to roughly 30% in some European cohorts. In the category of recreation and leisure most studies focused on socializing (n = 16). Patients with longstanding RA experienced a decrease in socializing (range, Cohen's d, -0.46 to -1.0), but changes over time were minor. RA patients experience restrictions in the performance of remunerative employment and in recreation and leisure (socializing). Due to the lack of studies, no conclusions on other ICF categories describing social roles could be made.

  15. Disability and Functional Profiles of Patients with Migraine Measured with ICF Classification

    ERIC Educational Resources Information Center

    Raggi, Alberto

    2010-01-01

    To describe the functional profiles of patients with migraine, and the relationships between symptoms, activities and environmental factors, using WHO's International Classification of Functioning (ICF). Patients were consecutively enrolled at the Besta Institute of Milan. The ICF checklist was administered and two count-based indexes developed:…

  16. ICF-CY: A Universal Tool for Documentation of Disability

    ERIC Educational Resources Information Center

    Simeonsson, Rune J.

    2009-01-01

    The "International Classification of Functioning, Disability and Health--ICF" (ICF-CY) conceptual framework offers a new paradigm and taxonomy of human functioning disability, which can be used to guide holistic and interdisciplinary approaches to assessment and intervention. In settings serving children, youth, or adults with disabilities, the…

  17. Regulating Professional Services in ICFs/MR: Remembering the Past and Looking to the Future.

    ERIC Educational Resources Information Center

    Sparr, Margaret P.; Smith, Wayne

    1990-01-01

    This article reviews regulations governing Intermediate Care Facilities for the Mentally Retarded (ICF/MR), including 1971 ICF/MR Medicaid funding legislation, standards development by professional consensus, development of federal regulations, intergovernmental roles, and possible directions for the future. A need is seen for professionals to…

  18. How a Regression Artifact Makes ICFs/MR Look Ineffective.

    ERIC Educational Resources Information Center

    Crinella, Francis M.; McCleary, Richard; Swanson, James M.

    1998-01-01

    Criticizes the research design in "The Small ICF/MR program: Dimensions of Quality and Cost" (Conroy), that found small Intermediate Care Facilities (ICF) for individuals with mental retardation are inferior to other community programs. Discusses the problem in selecting a control group on the basis of pretest matching. (CR)

  19. Easy-to-Read Informed Consent Forms for Hematopoietic Cell Transplantation Clinical Trials

    PubMed Central

    Denzen, Ellen M; Santibáñez, Martha E Burton; Moore, Heather; Foley, Amy; Gersten, Iris D; Gurgol, Cathy; Majhail, Navneet S; Spellecy, Ryan; Horowitz, Mary M; Murphy, Elizabeth A

    2011-01-01

    Informed consent is essential to ethical research and is requisite to participation in clinical research. Yet most hematopoietic cell transplantation (HCT) informed consent forms (ICFs) are written at reading levels that are above the ability of the average person in the US. The recent development of ICF templates by the National Cancer Institute, National Institutes of Health and the National Heart Blood and Lung Instituthas not resulted in increased patient comprehension of information. Barriers to creating Easy-to-Read ICFs that meet US federal requirements and pass Institutional Review Board (IRB) review are the result of multiple interconnected factors. The Blood and Marrow Transplant Clinical Trials Network (BMT CTN) formed an ad hoc review team to address concerns regarding the overall readability and length of ICFs used for BMT CTN trials. This paper summarizes recommendations of the review team for the development and formatting of Easy-to-Read ICFs for HCT multicenter clinical trials, the most novel of which is the use of a two-column layout. These recommendations intend to guide the ICF writing process, simplify local IRB review of the ICF, enhance patient comprehension and improve patient satisfaction. The BMT CTN plans to evaluate the impact of the Easy-to-Read format compared to the traditional format on the informed consent process. PMID:21806948

  20. Mapping the Mayo-Portland adaptability inventory to the international classification of functioning, disability and health.

    PubMed

    Lexell, Jan; Malec, James F; Jacobsson, Lars J

    2012-01-01

    To examine the contents of the Mayo-Portland Adaptability Inventory (MPAI-4) by mapping it to the International Classification of Functioning, Disability and Health (ICF). Each of the 30 scoreable items in the MPAI-4 was mapped to the most precise ICF categories. All 30 items could be mapped to components and categories in the ICF. A total of 88 meaningful concepts were identified. There were, on average, 2.9 meaningful concepts per item, and 65% of all concepts could be mapped. Items in the Ability and Adjustment subscales mapped to categories in both the Body Functions and Activity/Participation components of the ICF, whereas all except 1 in the Participation subscale were to categories in the Activity/Participation component. The items could also be mapped to 34 (13%) of the 258 Environmental Factors in the ICF. This mapping provides better definition through more concrete examples (as listed in the ICF) of the types of body functions, activities, and participation indicators that are represented by the 30 scoreable MPAI-4 items. This may assist users throughout the world in understanding the intent of each item, and support further development and the possibility to report results in the form of an ICF categorical profile, making it universally interpretable.

  1. Psychometric properties of the Chinese version of the pediatric quality of life inventory 4.0 Generic core scales among children with short stature.

    PubMed

    Wu, Hua-hong; Li, Hui; Gao, Qian

    2013-05-30

    The quality of life in children with short stature was rarely studied in China, so we explore these children's quality of life and psychometric properties of the Chinese version of the Pediatric Quality of Life Inventory 4.0(PedsQL4.0) Generic Core Scales among children with short stature. A total of 201 children aged 8 ~ 18 years from the short stature clinic and other clinics of capital institute of pediatrics attended this study. The questionnaires include demographic information and PedsQL4.0 generic core scales. According to children's height, we divided them into three groups: short stature, normal short and normal group, then compared the score of scales by the height category. Moreover, we analyzed the reliability and validity of PedsQL4.0 generic core scales in these 201 children. The child self-report total PedsQL mean score, for the short stature, normal short and normal groups were 77.77 ± 9.69, 83.50 ± 8.56 and 87.36 ± 7.23; the parent-proxy total PedsQL mean score were 77.62 ± 10.50, 82.69 ± 8.35 and 84.91 ± 9.96 respectively. Both for children self- and parent proxy-reports, the Cronbach's α coefficients of total scale, psychosocial health and social functioning ranged between 0.74 and 0.80, it ranged between 0.51 and 0.66 in other dimensions. For child self-reports, the correlation coefficients of 17 items' scores (total 23 items) with the scores of dimensions they belong to were above 0.5, with the highest 0.759; the other 6 items' correlation coefficients were below 0.5, with the lowest 0.280. For parent proxy-reports, the correlation coefficients of 19 items' scores with the scores of dimension they belong to were above 0.5, with the highest 0.793, the other 4 items' below 0.5 with the lowest 0.243. The quality of life in children with short stature is worse than their normal peers by Peds QL4.0 generic core scales, the statues of their quality of life was positively related to their stature.

  2. Development of the knee osteoarthritis patient education questionnaire: a new measure for evaluating preoperative patient education programmes for patients undergoing total knee replacement.

    PubMed

    Huber, Erika O; Bastiaenen, Caroline H; Bischoff-Ferrari, Heike A; Meichtry, André; de Bie, Rob A

    2015-01-01

    The aim of this study was to develop a generic instrument for the use of patients, named the Knee Osteoarthrtis Patient Education Questionnaire (KOPEQ), to assess the validity of a preoperative educational intervention and to make a preliminary test of its psychometric properties. A patient-reported outcome instrument was designed, using the conceptual framework of Wilson and Cleary as a methodological guide. Likert items with a five-point scale were chosen for the scoring option. The feasibility and interpretability of administering the KOPEQ was tested through conducting interviews with targeted patients. Items of the KOPEQ were linked to the International Classification of Functioning, Disability and Health (ICF). Psychometric testing contained internal consistency for reliability, and factor analysis for validity properties. A final list of 16 items was derived and linked to the ICF. Targeted patients confirmed in interviews, that all 16 questions were highly understandable and that the length of the questionnaire was feasible and acceptable. There was a good internal consistency for the 16-item KOPEQ with a Cronbach's alpha of 0.83 (95% confidence interval 0.71-0.94). Sixty-one percent of the variance was explained by a four-factor model and the factors were named "didactics", "addressability", "empowerment" and "theory". Results of a factor analysis provided a loading of the separate items between 0.469 and 0.958. The KOPEQ can help to provide health professionals with reliable feedback on how patients assessed the applied patient education intervention. Interviews with patients and a factor analysis revealed new and important insight.

  3. Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.

    PubMed

    Thyberg, Mikael; Arvidsson, Patrik; Thyberg, Ingrid; Nordenfelt, Lennart

    2015-01-01

    To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs. The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation. Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices. Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF. The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

  4. Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project).

    PubMed

    Sverker, Annette; Östlund, Gunnel; Thyberg, Mikael; Thyberg, Ingrid; Valtersson, Eva; Björk, Mathilda

    2015-01-01

    To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.

  5. Using Technology to Support the Army Learning Model

    DTIC Science & Technology

    2016-02-01

    Jessie Hyland ICF International Jennifer S. Tucker Steve Burnett U.S. Army Research Institute February 2016 United States...Director Research accomplished under contract for the Department of the Army by ICF International Technical Review by Jean Dyer...PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) ICF International U. S. Army Research Institute 9300 Lee Highway

  6. 42 CFR 440.150 - Intermediate care facility (ICF/IID) services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Intermediate care facility (ICF/IID) services. 440.150 Section 440.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.150 Intermediate care facility (ICF/IID)...

  7. Rhetoric and Realities in Today's ICF/MR: Control out of Control.

    ERIC Educational Resources Information Center

    Holburn, C. Steve

    1992-01-01

    This paper contrasts the rhetoric of quality assurance with the realities of poor quality in today's Intermediate Care Facilities for the Mentally Retarded (ICF/MR). The ICF/MR operational model is described as paper oriented, failure based, and insensitive to the effects of its own practices. Recommendations include the establishment of local…

  8. 42 CFR 440.150 - Intermediate care facility (ICF/MR) services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Intermediate care facility (ICF/MR) services. 440.150 Section 440.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.150 Intermediate care facility (ICF/MR) service...

  9. An Examination of a University Success Coaching Program

    ERIC Educational Resources Information Center

    Blankenship, Marlin

    2017-01-01

    This dissertation builds upon previous coaching research by providing a deep examination of a university success coaching program that uses an International Coach Federation (ICF) coaching framework. The dissertation seeks to identify how ICF coaching compares to the findings of previous research, what training is required to be an ICF coach at a…

  10. Progressive intervention strategy for the gait of sub-acute stroke patient using the International Classification of Functioning, Disability, and Health tool.

    PubMed

    Kang, Tae-Woo; Cynn, Heon-Seock

    2017-01-01

    The International Classification of Functioning, Disability, and Health (ICF) provides models for functions and disabilities. The ICF is presented as a frame that enables organizing physical therapists' clinical practice for application. The purpose of the present study was to describe processes through which stroke patients are assessed and treated based on the ICF model. The patient was a 65-year-old female diagnosed with right cerebral artery infarction with left hemiparesis. Progressive interventions were applied, such as those aiming at sitting and standing for the first two weeks, gait intervention for the third and fourth weeks, and those aiming at sitting from a standing position for the fifth and sixth weeks. The ICF model provides rehabilitation experts with a frame that enables them to accurately identify and understand their patients' problems. The ICF model helps the experts understand not only their patients' body structure, function, activity, and participation, but also their problems related to personal and environmental factors. The experts could efficiently make decisions and provide optimum treatment at clinics using the ICF model.

  11. Detection of incidental cardiac findings in noncardiac chest computed tomography

    PubMed Central

    Secchi, Francesco; Di Leo, Giovanni; Zanardo, Moreno; Alì, Marco; Cannaò, Paola Maria; Sardanelli, Francesco

    2017-01-01

    Abstract The aim of the study was to estimate the rate of incidental cardiac findings (ICF) in patients undergoing noncardiac chest CT. An experienced radiologist retrospectively reviewed 237 consecutive patients (147 males and 90 females with median age of 69 years) undergoing a noncardiac chest CT. ICF at targeted review were compared to those mentioned in original reports (χ2 test). At review, ≥1 ICF was detected in 124/237 patients (52%), for a total of 229 ICF, 158 of them (69%) not originally mentioned. Valvular calcifications were unmentioned in 23/23 (100%) patients, main pulmonary artery dilation in 21/22 (96%), coronary calcifications in 69/86 (80%), right or left atrial dilation in 7/11 (64%), aortic atherosclerosis in 29/62 (47%), and ascending aorta dilatation in 8/18 (44%). All 6 pericardial effusions were originally mentioned. No association with sex (P ≥ .189); positive correlation with age (P < .001). Half of patients undergoing noncardiac chest CT presented ≥1 ICF, independently from sex but increasing with age. Moreover, 69% of detectable ICFs were not originally mentioned. PMID:28723768

  12. Detection of incidental cardiac findings in noncardiac chest computed tomography.

    PubMed

    Secchi, Francesco; Di Leo, Giovanni; Zanardo, Moreno; Alì, Marco; Cannaò, Paola Maria; Sardanelli, Francesco

    2017-07-01

    The aim of the study was to estimate the rate of incidental cardiac findings (ICF) in patients undergoing noncardiac chest CT.An experienced radiologist retrospectively reviewed 237 consecutive patients (147 males and 90 females with median age of 69 years) undergoing a noncardiac chest CT. ICF at targeted review were compared to those mentioned in original reports (χ test).At review, ≥1 ICF was detected in 124/237 patients (52%), for a total of 229 ICF, 158 of them (69%) not originally mentioned. Valvular calcifications were unmentioned in 23/23 (100%) patients, main pulmonary artery dilation in 21/22 (96%), coronary calcifications in 69/86 (80%), right or left atrial dilation in 7/11 (64%), aortic atherosclerosis in 29/62 (47%), and ascending aorta dilatation in 8/18 (44%). All 6 pericardial effusions were originally mentioned. No association with sex (P ≥ .189); positive correlation with age (P < .001).Half of patients undergoing noncardiac chest CT presented ≥1 ICF, independently from sex but increasing with age. Moreover, 69% of detectable ICFs were not originally mentioned.

  13. The Nova Upgrade Facility for ICF ignition and gain

    NASA Astrophysics Data System (ADS)

    Lowdermilk, W. H.; Campbell, E. M.; Hunt, J. T.; Murray, J. R.; Storm, E.; Tobin, M. T.; Trenholme, J. B.

    1992-01-01

    Research on Inertial Confinement Fusion (ICF) is motivated by its potential defense and civilian applications, including ultimately the generation of electric power. The U.S. ICF Program was reviewed recently by the National Academy of Science (NAS) and the Fusion Policy Advisory Committee (FPAC). Both committees issued final reports in 1991 which recommended that first priority in the ICF program be placed on demonstrating fusion ignition and modest gain (G less than 10). The U.S. Department of Energy and Lawrence Livermore National Laboratory (LLNL) have proposed an upgrade of the existing Nova Laser Facility at LLNL to accomplish these goals. Both the NAS and FPAC have endorsed the upgrade of Nova as the optimal path to achieving ignition and gain. Results from Nova Upgrade Experiments will be used to define requirements for driver and target technology both for future high-yield military applications, such as the Laboratory Microfusion Facility (LMF) proposed by the Department of Energy, and for high-gain energy applications leading to an ICF engineering test facility. The central role and modifications which Nova Upgrade would play in the national ICF strategy are described.

  14. Space Generic Open Avionics Architecture (SGOAA): Overview

    NASA Technical Reports Server (NTRS)

    Wray, Richard B.; Stovall, John R.

    1992-01-01

    A space generic open avionics architecture created for NASA is described. It will serve as the basis for entities in spacecraft core avionics, capable of being tailored by NASA for future space program avionics ranging from small vehicles such as Moon ascent/descent vehicles to large ones such as Mars transfer vehicles or orbiting stations. The standard consists of: (1) a system architecture; (2) a generic processing hardware architecture; (3) a six class architecture interface model; (4) a system services functional subsystem architectural model; and (5) an operations control functional subsystem architectural model.

  15. A Nonlinear Dynamic Inversion Predictor-Based Model Reference Adaptive Controller for a Generic Transport Model

    NASA Technical Reports Server (NTRS)

    Campbell, Stefan F.; Kaneshige, John T.

    2010-01-01

    Presented here is a Predictor-Based Model Reference Adaptive Control (PMRAC) architecture for a generic transport aircraft. At its core, this architecture features a three-axis, non-linear, dynamic-inversion controller. Command inputs for this baseline controller are provided by pilot roll-rate, pitch-rate, and sideslip commands. This paper will first thoroughly present the baseline controller followed by a description of the PMRAC adaptive augmentation to this control system. Results are presented via a full-scale, nonlinear simulation of NASA s Generic Transport Model (GTM).

  16. The VISTA spacecraft: Advantages of ICF (Inertial Confinement Fusion) for interplanetary fusions propulsion applications

    NASA Technical Reports Server (NTRS)

    Orth, Charles D.; Klein, Gail; Sercel, Joel; Hoffman, Nate; Murray, Kathy; Chang-Diaz, Franklin

    1987-01-01

    Inertial Confinement Fusion (ICF) is an attractive engine power source for interplanetary manned spacecraft, especially for near-term missions requiring minimum flight duration, because ICF has inherent high power-to-mass ratios and high specific impulses. We have developed a new vehicle concept called VISTA that uses ICF and is capable of round-trip manned missions to Mars in 100 days using A.D. 2020 technology. We describe VISTA's engine operation, discuss associated plasma issues, and describe the advantages of DT fuel for near-term applications. Although ICF is potentially superior to non-fusion technologies for near-term interplanetary transport, the performance capabilities of VISTA cannot be meaningfully compared with those of magnetic-fusion systems because of the lack of a comparable study of the magnetic-fusion systems. We urge that such a study be conducted.

  17. CopperCore Service Integration

    ERIC Educational Resources Information Center

    Vogten, Hubert; Martens, Harrie; Nadolski, Rob; Tattersall, Colin; van Rosmalen, Peter; Koper, Rob

    2007-01-01

    In an e-learning environment there is a need to integrate various e-learning services like assessment services, collaboration services, learning design services and communication services. In this article we present the design and implementation of a generic integrative service framework, called CopperCore Service Integration (CCSI). We will…

  18. Industry Application ECCS / LOCA Integrated Cladding/Emergency Core Cooling System Performance: Demonstration of LOTUS-Baseline Coupled Analysis of the South Texas Plant Model

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhang, Hongbin; Szilard, Ronaldo; Epiney, Aaron

    Under the auspices of the DOE LWRS Program RISMC Industry Application ECCS/LOCA, INL has engaged staff from both South Texas Project (STP) and the Texas A&M University (TAMU) to produce a generic pressurized water reactor (PWR) model including reactor core, clad/fuel design and systems thermal hydraulics based on the South Texas Project (STP) nuclear power plant, a 4-Loop Westinghouse PWR. A RISMC toolkit, named LOCA Toolkit for the U.S. (LOTUS), has been developed for use in this generic PWR plant model to assess safety margins for the proposed NRC 10 CFR 50.46c rule, Emergency Core Cooling System (ECCS) performance duringmore » LOCA. This demonstration includes coupled analysis of core design, fuel design, thermalhydraulics and systems analysis, using advanced risk analysis tools and methods to investigate a wide range of results. Within this context, a multi-physics best estimate plus uncertainty (MPBEPU) methodology framework is proposed.« less

  19. Impact of first-principles properties of deuterium-tritium on inertial confinement fusion target designsa)

    NASA Astrophysics Data System (ADS)

    Hu, S. X.; Goncharov, V. N.; Boehly, T. R.; McCrory, R. L.; Skupsky, S.; Collins, L. A.; Kress, J. D.; Militzer, B.

    2015-05-01

    A comprehensive knowledge of the properties of high-energy-density plasmas is crucial to understanding and designing low-adiabat, inertial confinement fusion (ICF) implosions through hydrodynamic simulations. Warm-dense-matter (WDM) conditions are routinely accessed by low-adiabat ICF implosions, in which strong coupling and electron degeneracy often play an important role in determining the properties of warm dense plasmas. The WDM properties of deuterium-tritium (DT) mixtures and ablator materials, such as the equation of state, thermal conductivity, opacity, and stopping power, were usually estimated by models in hydro-codes used for ICF simulations. In these models, many-body and quantum effects were only approximately taken into account in the WMD regime. Moreover, the self-consistency among these models was often missing. To examine the accuracy of these models, we have systematically calculated the static, transport, and optical properties of warm dense DT plasmas, using first-principles (FP) methods over a wide range of densities and temperatures that cover the ICF "path" to ignition. These FP methods include the path-integral Monte Carlo (PIMC) and quantum-molecular dynamics (QMD) simulations, which treat electrons with many-body quantum theory. The first-principles equation-of-state table, thermal conductivities (κQMD), and first principles opacity table of DT have been self-consistently derived from the combined PIMC and QMD calculations. They have been compared with the typical models, and their effects to ICF simulations have been separately examined in previous publications. In this paper, we focus on their combined effects to ICF implosions through hydro-simulations using these FP-based properties of DT in comparison with the usual model simulations. We found that the predictions of ICF neutron yield could change by up to a factor of ˜2.5; the lower the adiabat of DT capsules, the more variations in hydro-simulations. The FP-based properties of DT are essential for designing ICF ignition targets. Future work on first-principles studies of ICF ablator materials is also discussed.

  20. Health professionals identify components of the International Classification of Functioning, Disability and Health (ICF) in questionnaires for the upper limb

    PubMed Central

    Philbois, Stella V.; Martins, Jaqueline; Souza, Cesário S.; Sampaio, Rosana F.; Oliveira, Anamaria S.

    2016-01-01

    BACKGROUND: Several Brazilian studies have addressed the International Classification of Functioning, Disability and Health (ICF), but few have analyzed the knowledge of the health professionals with regards to the ICF. OBJECTIVE: To verify whether the classification of the items in the Brazilian-Portuguese versions of The Shoulder Pain and Disability Index (SPADI) and The Disabilities Arm, Shoulder and Hand (DASH) questionnaires, obtained from health professionals who worked with patients having upper limb injuries, could be related to ICF components as defined by others studies. METHOD: There were 4 participants for the group "professionals with high familiarity of the ICF (PHF)" and 19 for the group of "professionals with some or no familiarity of the ICF (PSNF)". The participants judged whether the items on the two questionnaires belonged to the ICF body function, body structure or activity-participation component, and marked a confidence level for each trial using a numerical scale ranging from zero to 10. The items were classified by the discriminant content validity method using the Student'st-test and the Hochberg correction. The ratings were compared to the literature by the percentage of agreement and Kappa coefficient. RESULTS: The percentage of agreement of the rating from the PSNF and the PHF groups with the literature was equal to or greater than 77%. For the DASH, the agreement of the PSNF and PHF groups with the literature were, respectively, moderate (Kappa=0.46 to 0.48) and substantial (Kappa=0.62 to 0.70). CONCLUSIONS: Health professionals were able to correlate the three components of the ICF for most items on the 2 questionnaires, demonstrating some ease of understanding the ICF components. However, the relation of concept of pain with body function component is not clear for professional and deserves a more attentive approach. PMID:26786076

  1. ICF-CY code set for infants with early delay and disabilities (EDD Code Set) for interdisciplinary assessment: a global experts survey.

    PubMed

    Pan, Yi-Ling; Hwang, Ai-Wen; Simeonsson, Rune J; Lu, Lu; Liao, Hua-Fang

    2015-01-01

    Comprehensive description of functioning is important in providing early intervention services for infants with developmental delay/disabilities (DD). A code set of the International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY) could facilitate the practical use of the ICF-CY in team evaluation. The purpose of this study was to derive an ICF-CY code set for infants under three years of age with early delay and disabilities (EDD Code Set) for initial team evaluation. The EDD Code Set based on the ICF-CY was developed on the basis of a Delphi survey of international professionals experienced in implementing the ICF-CY and professionals in early intervention service system in Taiwan. Twenty-five professionals completed the Delphi survey. A total of 82 ICF-CY second-level categories were identified for the EDD Code Set, including 28 categories from the domain Activities and Participation, 29 from body functions, 10 from body structures and 15 from environmental factors. The EDD Code Set of 82 ICF-CY categories could be useful in multidisciplinary team evaluations to describe functioning of infants younger than three years of age with DD, in a holistic manner. Future validation of the EDD Code Set and examination of its clinical utility are needed. The EDD Code Set with 82 essential ICF-CY categories could be useful in the initial team evaluation as a common language to describe functioning of infants less than three years of age with developmental delay/disabilities, with a more holistic view. The EDD Code Set including essential categories in activities and participation, body functions, body structures and environmental factors could be used to create a functional profile for each infant with special needs and to clarify the interaction of child and environment accounting for the child's functioning.

  2. Clinical Significance of Accounting for Tissue Heterogeneity in Permanent Breast Seed Implant Brachytherapy Planning

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mashouf, Shahram; Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario; Fleury, Emmanuelle

    Purpose: The inhomogeneity correction factor (ICF) method provides heterogeneity correction for the fast calculation TG43 formalism in seed brachytherapy. This study compared ICF-corrected plans to their standard TG43 counterparts, looking at their capacity to assess inadequate coverage and/or risk of any skin toxicities for patients who received permanent breast seed implant (PBSI). Methods and Materials: Two-month postimplant computed tomography scans and plans of 140 PBSI patients were used to calculate dose distributions by using the TG43 and the ICF methods. Multiple dose-volume histogram (DVH) parameters of clinical target volume (CTV) and skin were extracted and compared for both ICF and TG43more » dose distributions. Short-term (desquamation and erythema) and long-term (telangiectasia) skin toxicity data were available on 125 and 110 of the patients, respectively, at the time of the study. The predictive value of each DVH parameter of skin was evaluated using the area under the receiver operating characteristic (ROC) curve for each toxicity endpoint. Results: Dose-volume histogram parameters of CTV, calculated using the ICF method, showed an overall decrease compared to TG43, whereas those of skin showed an increase, confirming previously reported findings of the impact of heterogeneity with low-energy sources. The ICF methodology enabled us to distinguish patients for whom the CTV V{sub 100} and V{sub 90} are up to 19% lower compared to TG43, which could present a risk of recurrence not detected when heterogeneity are not accounted for. The ICF method also led to an increase in the prediction of desquamation, erythema, and telangiectasia for 91% of skin DVH parameters studied. Conclusions: The ICF methodology has the advantage of distinguishing any inadequate dose coverage of CTV due to breast heterogeneity, which can be missed by TG43. Use of ICF correction also led to an increase in prediction accuracy of skin toxicities in most cases.« less

  3. What explains health in persons with visual impairment?

    PubMed Central

    2014-01-01

    Background Visual impairment is associated with important limitations in functioning. The International Classification of Functioning, Disability and Health (ICF) adopted by the World Health Organisation (WHO) relies on a globally accepted framework for classifying problems in functioning and the influence of contextual factors. Its comprehensive perspective, including biological, individual and social aspects of health, enables the ICF to describe the whole health experience of persons with visual impairment. The objectives of this study are (1) to analyze whether the ICF can be used to comprehensively describe the problems in functioning of persons with visual impairment and the environmental factors that influence their lives and (2) to select the ICF categories that best capture self-perceived health of persons with visual impairment. Methods Data from 105 persons with visual impairment were collected, including socio-demographic data, vision-related data, the Extended ICF Checklist and the visual analogue scale of the EuroQoL-5D, to assess self-perceived health. Descriptive statistics and a Group Lasso regression were performed. The main outcome measures were functioning defined as impairments in Body functions and Body structures, limitations in Activities and restrictions in Participation, influencing Environmental factors and self-perceived health. Results In total, 120 ICF categories covering a broad range of Body functions, Body structures, aspects of Activities and Participation and Environmental factors were identified. Thirteen ICF categories that best capture self-perceived health were selected based on the Group Lasso regression. While Activities-and-Participation categories were selected most frequently, the greatest impact on self-perceived health was found in Body-functions categories. The ICF can be used as a framework to comprehensively describe the problems of persons with visual impairment and the Environmental factors which influence their lives. Conclusions There are plenty of ICF categories, Environmental-factors categories in particular, which are relevant to persons with visual impairment, but have hardly ever been taken into consideration in literature and visual impairment-specific patient-reported outcome measures. PMID:24886326

  4. Clinical Significance of Accounting for Tissue Heterogeneity in Permanent Breast Seed Implant Brachytherapy Planning.

    PubMed

    Mashouf, Shahram; Fleury, Emmanuelle; Lai, Priscilla; Merino, Tomas; Lechtman, Eli; Kiss, Alex; McCann, Claire; Pignol, Jean-Philippe

    2016-03-15

    The inhomogeneity correction factor (ICF) method provides heterogeneity correction for the fast calculation TG43 formalism in seed brachytherapy. This study compared ICF-corrected plans to their standard TG43 counterparts, looking at their capacity to assess inadequate coverage and/or risk of any skin toxicities for patients who received permanent breast seed implant (PBSI). Two-month postimplant computed tomography scans and plans of 140 PBSI patients were used to calculate dose distributions by using the TG43 and the ICF methods. Multiple dose-volume histogram (DVH) parameters of clinical target volume (CTV) and skin were extracted and compared for both ICF and TG43 dose distributions. Short-term (desquamation and erythema) and long-term (telangiectasia) skin toxicity data were available on 125 and 110 of the patients, respectively, at the time of the study. The predictive value of each DVH parameter of skin was evaluated using the area under the receiver operating characteristic (ROC) curve for each toxicity endpoint. Dose-volume histogram parameters of CTV, calculated using the ICF method, showed an overall decrease compared to TG43, whereas those of skin showed an increase, confirming previously reported findings of the impact of heterogeneity with low-energy sources. The ICF methodology enabled us to distinguish patients for whom the CTV V100 and V90 are up to 19% lower compared to TG43, which could present a risk of recurrence not detected when heterogeneity are not accounted for. The ICF method also led to an increase in the prediction of desquamation, erythema, and telangiectasia for 91% of skin DVH parameters studied. The ICF methodology has the advantage of distinguishing any inadequate dose coverage of CTV due to breast heterogeneity, which can be missed by TG43. Use of ICF correction also led to an increase in prediction accuracy of skin toxicities in most cases. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention--feasibility and usefulness as a common language and frame of reference for practice.

    PubMed

    Björck-Åkesson, Eva; Wilder, Jenny; Granlund, Mats; Pless, Mia; Simeonsson, Rune; Adolfsson, Margareta; Almqvist, Lena; Augustine, Lilly; Klang, Nina; Lillvist, Anne

    2010-01-01

    Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.

  6. Using the ICF to clarify team roles and demonstrate clinical reasoning in stroke rehabilitation.

    PubMed

    Tempest, Stephanie; McIntyre, Anne

    2006-05-30

    The International Classification of Functioning, Disability and Health (ICF) is advocated as a tool to structure rehabilitation and a universal language to aid communication, within the multi-disciplinary team (MDT). The ICF may also facilitate clarification of team roles and clinical reasoning for intervention. This article aims to explore both factors in stroke rehabilitation. Following a review of the literature, a summary was presented and discussed with clinicians working within stroke rehabilitation, to gather expert opinions. The discussions were informal, being part of service development and on-going education. The clinicians summarised key themes for the potential use of the ICF within clinical practice. Two key themes emerged from the literature and expert opinion for the potential use of the ICF in stroke rehabilitation: (i) to aid communication and structure service provision, (ii) to clarify team roles and aid clinical reasoning. Expert opinion was that clarification of team roles needs to occur at a local level due to the skill mix, particular interests, setting and staffing levels within individual teams. The ICF has the potential to demonstrate/facilitate clinical reasoning, especially when different MDT members are working on the same intervention. There is potential for the ICF to be used to clarify team roles and demonstrate clinical reasoning within stroke rehabilitation. Further experiential research is required to substantiate this view.

  7. New amplifying laser concept for inertial fusion driver

    NASA Astrophysics Data System (ADS)

    Mourou, G. A.; Labaune, C.; Hulin, D.; Galvanauskas, A.

    2008-05-01

    This paper presents a new amplifying laser concept designed to produce high energy in either short or long pulses using coherent or incoherent addition of few millions fibers. These are called respectively CAN for Coherent Amplification Network and FAN for Fiber Amplification Network. The fibers would be large core or Large Mode Area (LMA) which have demonstrated up to 10, mJ output energy per fiber1. Such a system could meet the driver criteria of Inertial Fusion Energy (IFE) power plants based on Inertial Confinement Fusion (ICF), in particular high efficiency and high repetition rate.

  8. 42 CFR 442.118 - Denial of payments for new admissions to an ICF/MR.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... facility is out of compliance with the conditions of participation for ICFs/MR. (ii) A written decision... participation specified under subpart I of part 483 of this chapter. (b) Agency procedures. Before denying... participation for ICFs/MR. (2) If at the end of the specified period the facility has not achieved compliance...

  9. Relationship between work-related attitudes, performance and capacities according to the ICF in patients with mental disorders.

    PubMed

    Linden, Michael; Baron, Stefanie; Muschalla, Beate

    2010-01-01

    The International Classification of Functioning Disability and Health (ICF) differentiates between functions, activities/capacities, contextual factors and participation. Dysfunctions can result in impaired capacities, which in turn can lead to problems with participation depending on the context. Motivational and volitional deficits are intervening factors. The question is to what degree work performance (i.e. participation), motivational factors, and the inability to perform activities (i.e. dysfunctions) interact. Incapacities were measured in 213 patients (70% women) admitted to the Department of Behavioral Medicine using the Mini-ICF-Rating for Mental Disorders (Mini-ICF-APP), work performance was measured with the Endicott Work Productivity Scale (EWPS), and volitional and motivational problems in regard to work were assessed with the Arbeitsbezogenes Verhaltens- und Erlebensmuster (AVEM). Sick leave prior to admission and work-related problems were assessed in a special clinical interview. The mean global score of the Mini-ICF-APP across all patients was 0.84 +/- 0.56 (SD), corresponding to 'mild disability'. The highest disabilities in this patient population were found for 'flexibility' (item 3, 1.64 +/- 0.94); the lowest disabilities were found for 'self maintenance' (item 11, 0.19 +/- 0.44) and 'mobility' (item 12, 0.43 +/- 0.85). Partial correlations between the Mini-ICF-APP, AVEM and EWPS showed highly significant correlations between the Mini-ICF-APP and EWPS and no or weak correlations between the AVEM and the Mini-ICF-APP or EWPS. Work performance is primarily related to the inability to perform activities and incapacities, and only due to attitudes or volitional/motivational factors to a much lesser degree. Therefore, capacity and motivation can and must be separated. Copyright (c) 2010 S. Karger AG, Basel.

  10. Applying the ICF to identify requirements for students with Asperger syndrome in higher education.

    PubMed

    Adolfsson, Margareta; Simmeborn Fleischer, Ann

    2015-06-01

    Higher education requires more than academic skills and everyday student-life can be stressful. Students with Asperger syndrome (AS) may need support to manage their education due to difficulties in social functioning. As preparation for the development of a structured tool to guide student and coordinator dialogues at Swedish universities, this study aimed to identify ICF categories that reflect requirements in everyday student-life for students with AS. Using descriptive qualitative approach, information in documents reflecting the perspectives of university students, international classifications, user/health organisations and education authorities were linked to ICF codes. In total, 114 ICF categories were identified, most of which related to learning, tasks and demands, communication and interactions. Students with AS need varying accommodations to be successful in higher education. In the future, ICF-based code sets, including demands on student roles, can be used as checklists to describe functioning and needs for support.

  11. A comparison of the International Classification of Functioning, Disability, and Health to the disability tax credit.

    PubMed

    Conti-Becker, Angela; Doralp, Samantha; Fayed, Nora; Kean, Crystal; Lencucha, Raphael; Leyshon, Rhysa; Mersich, Jackie; Robbins, Shawn; Doyle, Phillip C

    2007-01-01

    The Disability Tax Credit (DTC) Certification is an assessment tool used to provide Canadians with disability tax relief The International Classification of Functioning, Disability and Health (ICF) provides a universal framework for defining disability. The purpose of this study was to evaluate the DTC and familiarize occupational therapists with the process of mapping measures to the ICF classification system. Concepts within the DTC were identified and mapped to appropriate ICF codes (Cieza et al., 2005). The DTC was linked to 45 unique ICF codes (16 Body Functions, 19 Activities and Participation, and 8 Environmental Factors). The DTC encompasses various domains of the ICF; however, there is no consideration of Personal Factors, Body Structures, and key aspects of Activities and Participation. Refining the DTC to address these aspects will provide an opportunity for fair and just determinations for those who experience disability.

  12. Lawrence Livermore National Laboratories Perspective on Code Development and High Performance Computing Resources in Support of the National HED/ICF Effort

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Clouse, C. J.; Edwards, M. J.; McCoy, M. G.

    2015-07-07

    Through its Advanced Scientific Computing (ASC) and Inertial Confinement Fusion (ICF) code development efforts, Lawrence Livermore National Laboratory (LLNL) provides a world leading numerical simulation capability for the National HED/ICF program in support of the Stockpile Stewardship Program (SSP). In addition the ASC effort provides high performance computing platform capabilities upon which these codes are run. LLNL remains committed to, and will work with, the national HED/ICF program community to help insure numerical simulation needs are met and to make those capabilities available, consistent with programmatic priorities and available resources.

  13. Adolescents with Hearing Loss and the International Classification of Functioning, Health, and Disability: Children & Youth Version

    PubMed Central

    English, Kris; Pajevic, Emily

    2016-01-01

    In 2007, the World Health Organization published a set of International Classification of Functioning, Disability and Health (ICF) codes designed for children and youth (ICF-CY version). The ICF-CY considers typical developmental changes associated with childhood while describing health status and the effects of intervention. In this article we will describe how a specific intervention (transition planning for adolescents) can be documented with the ICF-CY. Transition planning in health care prepares adolescents and their families for the transfer from pediatric to adult health services and has been demonstrated to be an effective practice for adolescents with many types of chronic health conditions (e.g., cystic fibrosis, epilepsy, diabetes). Audiology has not yet addressed transition planning for adolescents with hearing loss; therefore, we propose using the ICF-CY to design a pathway of care. The ICF-CY can standardize transition planning to the benefit of both teen patients and audiologists: teens and their families would gradually acquire necessary knowledge and skills, and audiologists would develop a meaningful data set to help further inform our pediatric practices, as well as give more structure, depth, and accountability to our role in rehabilitation. PMID:27489402

  14. Nature and the natural environment as health facilitators: the need to reconceptualize the ICF environmental factors.

    PubMed

    Day, Adam M B; Theurer, Julie A; Dykstra, Allyson D; Doyle, Philip C

    2012-01-01

    This work examines the environmental factors component of the International Classification of Functioning, Disability, and Health (ICF) relative to current health-facilitating evidence about natural environmental factors. We argue that the environmental factors component warrants reconceptualization in order to offer an extended and more systematic framework for identifying and measuring health-facilitating natural environmental factors. Current evidence highlighting the potential health-facilitating benefits of natural environmental factors is synthesized and considered in the context of the ICF framework and its coding system. In its current form, the ICF's conceptual framework and coding system are inadequate for identifying and measuring natural environmental factors in individuals and groups with and/or without health conditions. The ICF provides an advanced framework for health and disability that reflects contemporary conceptualizations about health. However, given the scope of emerging evidence highlighting positive health and well-being outcomes associated with natural environmental factors, we believe the environmental factors component requires further advancement to reflect this current knowledge. Reconceptualizing the environmental factors component supports a more holistic interpretation of the continuum of environmental factors as both facilitators and barriers. In doing so, it strengthens the ICF's utility in identifying and measuring health-facilitating natural environmental factors.

  15. Developing applications of the ICF in education systems: addressing issues of knowledge creation, management and transfer.

    PubMed

    Hollenweger, Judith

    2013-06-01

    Since its endorsement, the International Classification of Functioning, Disability and Health (ICF) has been applied in many policy contexts, including education. While so far the focus has been on showing ways in which it can be used to describe functioning and disability, this article seeks to focus on its value to represent knowledge. Two applications of the ICF and ICF-CY in the context of the Swiss education system highlight ways in which the classification can be used to assist multidisciplinary teams in acquiring and mapping existing knowledge, in creating new knowledge and in applying it for specific purposes. The conceptual analysis illustrates that "disability in education" is a hybrid conceptual world that needs to bridge disability-related information with information relevant for learning and education. The ICF can be used to adequately map such knowledge in complex social settings. More attention needs to be paid to the ICF as an information system to help negotiate between different views on reality and different areas of expertise. The selection of content and ways of representing it need to be considered in the light of the specific purposes during collaborative knowledge creation processes.

  16. Measuring health and disability: supporting policy development. The European MHADIE project.

    PubMed

    Leonardi, Matilde

    2010-01-01

    Disability is a multi-dimensional phenomenon arising out of an interaction between the individual's health status and his environment: disability data must reflect this bio-psychosocial model. WHO's International Classification of Functioning, Disability and Health (ICF) provides the framework for documenting the interaction between health status and environmental features. MHADIE, a 3-year project supported by a EC 6th Framework Programme Grant, aimed at demonstrating the feasibility and utility of the ICF model in the measurement and description of disability. The ICF model was used as the structure for analysing existing population health surveys and education statistics data. ICF-based tools were used to describe disability in selected health conditions. MHADIE researchers showed that the ICF model is adequate for describing and measuring patterns of disability in clinical samples from different countries cross-sectionally and over time as well as feasible and useful in educational sectors. Valid and reliable information are essential to design, implement or evaluate policies to combat discrimination, promote integration and enhance opportunities. Results made it possible to produce a definition of disability as well as policy recommendations concerning how, in Europe and internationally, the existing sources of data can be harmonized with the ICF model.

  17. The use of the International Classification of Functioning, Disability and Health to understand the health and functioning experiences of people with chronic conditions from the person perspective: a systematic review.

    PubMed

    Alford, Vanessa M; Ewen, Shaun; Webb, Gillian R; McGinley, Jenny; Brookes, Alison; Remedios, Louisa J

    2015-01-01

    This systematic review examines the literature to identify the context and extent of implementation of the International Classification of Functioning, Disability and Health (ICF) model to understand the experience of health and functioning in persons with chronic conditions from the person perspective. The literature search was conducted through five electronic databases between 2001 and December 2012. Reference lists of included papers were also searched. Articles in which the ICF was used to understand the health and functioning experience of adults with chronic conditions from the person-perspective were included. Data were extracted and analysed to identify the year of publication, geographical location, health condition, context of ICF use, authors' remarks and identified limitations of the ICF. Thirty-seven qualitative and mixed-methods studies were included representing 18 countries and a range of chronic conditions. The ICF was found to be used to elicit and analyse people's narratives, with the majority of studies reporting that the ICF provides a comprehensive analysis of experiences and needs from the person perspective. Some limitations to its use and the need to classify the "personal factors" component were reported. The ICF has been used to provide a comprehensive understanding of health and functioning in persons with chronic conditions from the person perspective, although there are currently relatively few studies which have used the ICF in this context. Limitations regarding its use were reported which should be considered by users of the model and during its revision process. The ICF encourages a bio-psycho-social and person-centred approach to healthcare and may provide a useful tool for guiding clinical assessment and encouraging clinicians to consider the multitude of factors which impact health, which may result in more specific and individualised treatment targeted at individual needs. Using a common framework that can be understood across health disciplines may enhance interdisciplinary communication and collaboration, improving health care delivery. The ICF may be used to compare perspectives of individuals and their health professionals and to identify people's needs that are not adequately being addressed, which may have significant implications for improving healthcare provided and overall health outcomes.

  18. Combined application of the International Classification of Functioning, Disability and Health and the NANDA-International Taxonomy II.

    PubMed

    Boldt, Christine; Grill, Eva; Bartholomeyczik, Sabine; Brach, Mirjam; Rauch, Alexandra; Eriks-Hoogland, Inge; Stucki, Gerold

    2010-08-01

    This paper presents a discussion of the conceptual and practical relationships between the International Classification of Functioning, Disability and Health and the NANDA-International Taxonomy II for nursing diagnoses, and their use in nursing practice. The ICF provides a common classification framework for all healthcare professionals, including nurses. Nursing care plans can be broadly based on NANDA-I taxonomies. No published attempt has been made to systematically compare the NANDA-I Taxonomy II to the ICF. The most recently published descriptions of both classifications and a case example presenting the combined use of both classifications. The work was carried out in 2009. There are conceptual commonalities and differences between the ICF and the NANDA-I Taxonomy II. In the case example, the overlap between the ICF categories and NANDA-I nursing diagnoses reflects the fact that the ICF, focusing on functioning and disability, and the NANDA-I Taxonomy II, with its functioning health patterns, are similar in their approaches. The NANDA-I Taxonomy II permits the fulfilment of requirements that are exclusively nursing issues. The application of the ICF is useful for nurses to communicate nursing issues with other healthcare professionals in a common language. For nurses, knowledge shared with other healthcare professionals may contribute to broader understanding of a patient's situation. The ICF and the NANDA-I Taxonomy II should be used in concert by nurses and can complement each other to enhance the quality of clinical team work and nursing practice.

  19. Understanding reliability and some limitations of the images and spectra reconstructed from a multi-monochromatic x-ray imager

    DOE PAGES

    Nagayama, T.; Mancini, R. C.; Mayes, D.; ...

    2015-11-18

    Temperature and density asymmetry diagnosis is critical to advance inertial confinement fusion (ICF) science. A multi-monochromatic x-ray imager (MMI) is an attractive diagnostic for this purpose. The MMI records the spectral signature from an ICF implosion core with time resolution, 2-D space resolution, and spectral resolution. While narrow-band images and 2-D space-resolved spectra from the MMI data constrain temperature and density spatial structure of the core, the accuracy of the images and spectra depends not only on the quality of the MMI data but also on the reliability of the post-processing tools. In this paper, we synthetically quantify the accuracymore » of images and spectra reconstructed from MMI data. Errors in the reconstructed images are less than a few percent when the space-resolution effect is applied to the modeled images. The errors in the reconstructed 2-D space-resolved spectra are also less than a few percent except those for the peripheral regions. Spectra reconstructed for the peripheral regions have slightly but systematically lower intensities by ~6% due to the instrumental spatial-resolution effects. However, this does not alter the relative line ratios and widths and thus does not affect the temperature and density diagnostics. We also investigate the impact of the pinhole size variation on the extracted images and spectra. A 10% pinhole size variation could introduce spatial bias to the images and spectra of ~10%. A correction algorithm is developed, and it successfully reduces the errors to a few percent. Finally, it is desirable to perform similar synthetic investigations to fully understand the reliability and limitations of each MMI application.« less

  20. Understanding reliability and some limitations of the images and spectra reconstructed from a multi-monochromatic x-ray imager

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nagayama, T.; Mancini, R. C.; Mayes, D.

    2015-11-15

    Temperature and density asymmetry diagnosis is critical to advance inertial confinement fusion (ICF) science. A multi-monochromatic x-ray imager (MMI) is an attractive diagnostic for this purpose. The MMI records the spectral signature from an ICF implosion core with time resolution, 2-D space resolution, and spectral resolution. While narrow-band images and 2-D space-resolved spectra from the MMI data constrain temperature and density spatial structure of the core, the accuracy of the images and spectra depends not only on the quality of the MMI data but also on the reliability of the post-processing tools. Here, we synthetically quantify the accuracy of imagesmore » and spectra reconstructed from MMI data. Errors in the reconstructed images are less than a few percent when the space-resolution effect is applied to the modeled images. The errors in the reconstructed 2-D space-resolved spectra are also less than a few percent except those for the peripheral regions. Spectra reconstructed for the peripheral regions have slightly but systematically lower intensities by ∼6% due to the instrumental spatial-resolution effects. However, this does not alter the relative line ratios and widths and thus does not affect the temperature and density diagnostics. We also investigate the impact of the pinhole size variation on the extracted images and spectra. A 10% pinhole size variation could introduce spatial bias to the images and spectra of ∼10%. A correction algorithm is developed, and it successfully reduces the errors to a few percent. It is desirable to perform similar synthetic investigations to fully understand the reliability and limitations of each MMI application.« less

  1. Understanding reliability and some limitations of the images and spectra reconstructed from a multi-monochromatic x-ray imager.

    PubMed

    Nagayama, T; Mancini, R C; Mayes, D; Tommasini, R; Florido, R

    2015-11-01

    Temperature and density asymmetry diagnosis is critical to advance inertial confinement fusion (ICF) science. A multi-monochromatic x-ray imager (MMI) is an attractive diagnostic for this purpose. The MMI records the spectral signature from an ICF implosion core with time resolution, 2-D space resolution, and spectral resolution. While narrow-band images and 2-D space-resolved spectra from the MMI data constrain temperature and density spatial structure of the core, the accuracy of the images and spectra depends not only on the quality of the MMI data but also on the reliability of the post-processing tools. Here, we synthetically quantify the accuracy of images and spectra reconstructed from MMI data. Errors in the reconstructed images are less than a few percent when the space-resolution effect is applied to the modeled images. The errors in the reconstructed 2-D space-resolved spectra are also less than a few percent except those for the peripheral regions. Spectra reconstructed for the peripheral regions have slightly but systematically lower intensities by ∼6% due to the instrumental spatial-resolution effects. However, this does not alter the relative line ratios and widths and thus does not affect the temperature and density diagnostics. We also investigate the impact of the pinhole size variation on the extracted images and spectra. A 10% pinhole size variation could introduce spatial bias to the images and spectra of ∼10%. A correction algorithm is developed, and it successfully reduces the errors to a few percent. It is desirable to perform similar synthetic investigations to fully understand the reliability and limitations of each MMI application.

  2. Impact of first-principles properties of deuterium–tritium on inertial confinement fusion target designs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hu, S. X., E-mail: shu@lle.rochester.edu; Goncharov, V. N.; Boehly, T. R.

    2015-05-15

    A comprehensive knowledge of the properties of high-energy-density plasmas is crucial to understanding and designing low-adiabat, inertial confinement fusion (ICF) implosions through hydrodynamic simulations. Warm-dense-matter (WDM) conditions are routinely accessed by low-adiabat ICF implosions, in which strong coupling and electron degeneracy often play an important role in determining the properties of warm dense plasmas. The WDM properties of deuterium–tritium (DT) mixtures and ablator materials, such as the equation of state, thermal conductivity, opacity, and stopping power, were usually estimated by models in hydro-codes used for ICF simulations. In these models, many-body and quantum effects were only approximately taken into accountmore » in the WMD regime. Moreover, the self-consistency among these models was often missing. To examine the accuracy of these models, we have systematically calculated the static, transport, and optical properties of warm dense DT plasmas, using first-principles (FP) methods over a wide range of densities and temperatures that cover the ICF “path” to ignition. These FP methods include the path-integral Monte Carlo (PIMC) and quantum-molecular dynamics (QMD) simulations, which treat electrons with many-body quantum theory. The first-principles equation-of-state table, thermal conductivities (κ{sub QMD}), and first principles opacity table of DT have been self-consistently derived from the combined PIMC and QMD calculations. They have been compared with the typical models, and their effects to ICF simulations have been separately examined in previous publications. In this paper, we focus on their combined effects to ICF implosions through hydro-simulations using these FP-based properties of DT in comparison with the usual model simulations. We found that the predictions of ICF neutron yield could change by up to a factor of ∼2.5; the lower the adiabat of DT capsules, the more variations in hydro-simulations. The FP-based properties of DT are essential for designing ICF ignition targets. Future work on first-principles studies of ICF ablator materials is also discussed.« less

  3. Compiling standardized information from clinical practice: using content analysis and ICF Linking Rules in a goal-oriented youth rehabilitation program.

    PubMed

    Lustenberger, Nadia A; Prodinger, Birgit; Dorjbal, Delgerjargal; Rubinelli, Sara; Schmitt, Klaus; Scheel-Sailer, Anke

    2017-09-23

    To illustrate how routinely written narrative admission and discharge reports of a rehabilitation program for eight youths with chronic neurological health conditions can be transformed to the International Classification of Functioning, Disability and Health. First, a qualitative content analysis was conducted by building meaningful units with text segments assigned of the reports to the five elements of the Rehab-Cycle ® : goal; assessment; assignment; intervention; evaluation. Second, the meaningful units were then linked to the ICF using the refined ICF Linking Rules. With the first step of transformation, the emphasis of the narrative reports changed to a process oriented interdisciplinary layout, revealing three thematic blocks of goals: mobility, self-care, mental, and social functions. The linked 95 unique ICF codes could be grouped in clinically meaningful goal-centered ICF codes. Between the two independent linkers, the agreement rate was improved after complementing the rules with additional agreements. The ICF Linking Rules can be used to compile standardized health information from narrative reports if prior structured. The process requires time and expertise. To implement the ICF into common practice, the findings provide the starting point for reporting rehabilitation that builds upon existing practice and adheres to international standards. Implications for Rehabilitation This study provides evidence that routinely collected health information from rehabilitation practice can be transformed to the International Classification of Functioning, Disability and Health by using the "ICF Linking Rules", however, this requires time and expertise. The Rehab-Cycle ® , including assessments, assignments, goal setting, interventions and goal evaluation, serves as feasible framework for structuring this rehabilitation program and ensures that the complexity of local practice is appropriately reflected. The refined "ICF Linking Rules" lead to a standardized transformation process of narrative text and thus a higher quality with increased transparency. As a next step, the resulting format of goal codes supplemented by goal-clarifying codes could be validated to strengthen the implementation of the International Classification of Functioning, Disability and Health into rehabilitation routine by respecting the variety of clinical practice.

  4. Impact of first-principles properties of deuterium–tritium on inertial confinement fusion target designs

    DOE PAGES

    Hu, S. X.; Goncharov, V. N.; Boehly, T. R.; ...

    2015-04-20

    In this study, a comprehensive knowledge of the properties of high-energy-density plasmas is crucial to understanding and designing low-adiabat, inertial confinement fusion (ICF) implosions through hydrodynamic simulations. Warm-dense-matter (WDM) conditions are routinely accessed by low-adiabat ICF implosions, in which strong coupling and electron degeneracy often play an important role in determining the properties of warm dense plasmas. The WDM properties of deuterium–tritium (DT) mixtures and ablator materials, such as the equation of state, thermal conductivity, opacity, and stopping power, were usually estimated by models in hydro-codes used for ICF simulations. In these models, many-body and quantum effects were only approximatelymore » taken into account in the WMD regime. Moreover, the self-consistency among these models was often missing. To examine the accuracy of these models, we have systematically calculated the static, transport, and optical properties of warm dense DT plasmas, using first-principles (FP) methods over a wide range of densities and temperatures that cover the ICF “path” to ignition. These FP methods include the path-integral Monte Carlo (PIMC) and quantum-molecular dynamics (QMD) simulations, which treat electrons with many-body quantum theory. The first-principles equation-of-state table, thermal conductivities (K QMD), and first principles opacity table of DT have been self-consistently derived from the combined PIMC and QMD calculations. They have been compared with the typical models, and their effects to ICF simulations have been separately examined in previous publications. In this paper, we focus on their combined effects to ICF implosions through hydro-simulations using these FP-based properties of DT in comparison with the usual model simulations. We found that the predictions of ICF neutron yield could change by up to a factor of –2.5; the lower the adiabat of DT capsules, the more variations in hydro-simulations. The FP-based properties of DT are essential for designing ICF ignition targets. Future work on first-principles studies of ICF ablator materials is also discussed.« less

  5. Psychometric properties of the International Classification of Functioning, Disability and Health set for spinal cord injury nursing based on Rasch analysis.

    PubMed

    Li, Kun; Yan, Tiebin; You, Liming; Xie, Sumei; Li, Yun; Tang, Jie; Wang, Yingmin; Gao, Yan

    2018-02-01

    To examine the psychometric properties of the International Classification of Functioning, Disability and Health (ICF) set for spinal cord injury nursing (ICF-SCIN) using Rasch analysis. A total of 140 spinal cord injury patients were recruited between December 2013 and March 2014 through convenience sampling. Nurses used the components body functions (BF), body structures (BS), and activities and participation (AP) of the ICF-SCIN to rate the patients' functioning. Rasch analysis was performed using RUMM 2030 software. In each component, categories were rescored from 01234 to 01112 because of reversed thresholds. Nine testlets were created to overcome local dependency. Four categories which fit to the Rasch model poorly were deleted. After modification, the components BF, BS, and AP showed good fit to the Rasch model with a Bonferroni-adjusted significant level (χ 2  =   86.29, p = 0.006; χ 2  =   22.44, p = 0.130; χ 2  =   39.92, p = 0.159). The person separation indices (PSIs) for the three components were 0.80, 0.54, and 0.97, respectively. No differential item functioning (DIF) was detected across age, gender, or educational level. The fit properties of the ICF set were satisfactory after modifications. The ICF-SCIN has the potential as a nursing assessment instrument for measuring the functioning of patients with spinal cord injury. Implications for rehabilitation The International Classification of Functioning, Disability and Health (ICF) set for spinal cord injury nursing contains a group of categories which can reflect the functioning of spinal cord injury patients from the perspective of nurses. The components body functions (BF), body structures (BS), and activities and participation (AP) of the ICF set for spinal cord injury achieved the fit to the Rasch model through rescoring, generating testlets, and deleting categories with poor fit. The ICF set for spinal cord injury nursing (ICF-SCIN) has the potential to be used as a clinical nursing assessment tool in measuring the functioning of patients with spinal cord injury.

  6. Applying the ICF framework to study changes in quality-of-life for youth with chronic conditions

    PubMed Central

    McDougall, Janette; Wright, Virginia; Schmidt, Jonathan; Miller, Linda; Lowry, Karen

    2011-01-01

    Objective The objective of this paper is to describe how the ICF framework was applied as the foundation for a longitudinal study of changes in quality-of-life (QoL) for youth with chronic conditions. Method This article will describe the study’s aims, methods, measures and data analysis techniques. It will point out how the ICF framework was used—and expanded upon—to provide a model for studying the impact of factors on changes in QoL for youth with chronic conditions. Further, it will describe the instruments that were chosen to measure the components of the ICF framework and the data analysis techniques that will be used to examine the impact of factors on changes in youths’ QoL. Conclusions Qualitative and longitudinal designs for studying QoL based on the ICF framework can be useful for unraveling the complex ongoing inter-relationships among functioning, contextual factors and individuals’ perceptions of their QoL. PMID:21034288

  7. What Is the International Classification of Functioning, Disability and Health and Why Is It Relevant to Audiology?

    PubMed Central

    Meyer, Carly; Grenness, Caitlin; Scarinci, Nerina; Hickson, Louise

    2016-01-01

    The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is widely used in disability and health sectors as a framework to describe the far-reaching effects of a range of health conditions on individuals. This biopsychosocial framework can be used to describe the experience of an individual in the components of body functions, body structures, and activities and participation, and it considers the influence of contextual factors (environmental and personal) on these components. Application of the ICF in audiology allows the use of a common language between health care professionals in both clinical and research settings. Furthermore, the ICF is promoted as a means of facilitating patient-centered care. In this article, the relevance and application of the ICF to audiology is described, along with clinical examples of its application in the assessment and management of children and adults with hearing loss. Importantly, the skills necessary for clinicians to apply the ICF effectively are discussed. PMID:27489397

  8. Unfolding/Refolding Study on Collagen from Sea Cucumber Based on 2D Fourier Transform Infrared Spectroscopy.

    PubMed

    Qin, Lei; Bi, Jing-Ran; Li, Dong-Mei; Dong, Meng; Zhao, Zi-Yuan; Dong, Xiu-Ping; Zhou, Da-Yong; Zhu, Bei-Wei

    2016-11-16

    We aimed to explore the differences of thermal behaviors between insoluble collagen fibrils (ICFs) and pepsin-solubilized collagens (PSCs) from sea cucumber Stichopus japonicus . The unfolding/refolding sequences of secondary structures of ICFs and PSCs during the heating and cooling cycle (5 → 70 → 5 °C) were identified by Fourier transform infrared spectrometry combined with curve-fitting and 2D correlation techniques. ICFs showed a higher proportion of α-helical structures and higher thermostability than PSCs, and thus had more-stable triple helical structures. The sequences of changes affecting the secondary structures during heating were essentially the same between ICFs and PSCs. In all cases, α-helix structure was the most important conformation and it disappeared to form a β-sheet structure. In the cooling cycle, ICFs showed a partially refolding ability, and the proportion of β-sheet structure rose before the increasing proportion of α-helix structure. PSCs did not obviously refold during the cooling stage.

  9. Kernel-Smoothing Estimation of Item Characteristic Functions for Continuous Personality Items: An Empirical Comparison with the Linear and the Continuous-Response Models

    ERIC Educational Resources Information Center

    Ferrando, Pere J.

    2004-01-01

    This study used kernel-smoothing procedures to estimate the item characteristic functions (ICFs) of a set of continuous personality items. The nonparametric ICFs were compared with the ICFs estimated (a) by the linear model and (b) by Samejima's continuous-response model. The study was based on a conditioned approach and used an error-in-variables…

  10. [Measuring Participation - Discussion of the Theoretical Foundations of Current Assessment Instruments].

    PubMed

    Gebhard, B; Fink, A

    2015-09-01

    For children and adolescents social participation is a central goal of rehabilitation processes. Available measurements and evaluation tools are exposed to the problem that the theoretical foundation of the construct of participation is still unclear as well as differentiation from activity in the International Classification of Functioning, Disabilities and Health (ICF/ICF-CY) of the WHO is not made sufficiently. The objectives of this article were (1) to illustrate the scientific discussions on the term and understanding of participation from rehabilitation science perspectives and (2) to conclude implications for practice and science. A systematic search for participation instruments was performed in MEDLINE, CINAHL, PsycINFO, ERIC und EMBASE in August 2014. The available instruments are based on very different definitions of participation. The discussion about the term seems to be not yet complete. A major demand is a better operationalization of activity and participation according to the ICF/ICF-CY in the instruments. Before using an existing instrument, the transferability should be tested for the own context. The theoretical assumptions of participation in conjunction to ICF/ICF-CY as well as the objectives of the instrument should all be clearly understood before using an existing instrument but also before the development of new instruments. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Measurement of activity limitations and participation restrictions: examination of ICF-linked content and scale properties of the FIM and PC-PART instruments.

    PubMed

    Darzins, Susan W; Imms, Christine; Di Stefano, Marilyn

    2017-05-01

    To explore the operationalization of activity and participation-related measurement constructs through comparison of item phrasing, item response categories and scoring (scale properties) for two separate instruments targeting activities of daily living. Personal Care Participation Assessment and Resource Tool (PC-PART) item content was linked to ICF categories using established linking rules. Previously reported ICF-linked FIM content categories and ICF-linked PC-PART content categories were compared to identify common ICF categories between the instruments. Scale properties of both instruments were compared using a patient scenario to explore the instruments' separate measurement constructs. The PC-PART and FIM shared 15 of the 53 level two ICF-linked categories identified across both instruments. Examination of the instruments' scale properties for items with overlapping ICF content, and exploration through a patient scenario, provided supportive evidence that the instruments measure different constructs. While the PC-PART and FIM share common ICF-linked content, they measure separate constructs. Measurement construct was influenced by the instruments' scale properties. The FIM was observed to measure activity limitations and the PC-PART measured participation restrictions. Scrutiny of instruments' scale properties in addition to item content is critical in the operationalization of activity and participation-related measurement constructs. Implications for Rehabilitation When selecting outcome measures for use in rehabilitation it is necessary to examine both the content of the instruments' items and item phrasing, response categories and scoring, to clarify the construct being measured. Measurement of activity limitations as well as participation restrictions in activities of daily living required for community life provides a more comprehensive measurement of rehabilitation outcomes than measurement of either construct alone. To measure the effects of interventions used in rehabilitation, it is necessary to select measures with relevant content and scale properties that enable evaluation of change in the constructs that are expected to change, as a result of the rehabilitation intervention.

  12. Readability of informed consent forms in clinical trials conducted in a skin research center

    PubMed Central

    Samadi, Aniseh; Asghari, Fariba

    2016-01-01

    Obtaining informed consents is one of the most fundamental principles in conducting a clinical trial. In order for the consent to be informed, the patient must receive and comprehend the information appropriately. Complexity of the consent form is a common problem that has been shown to be a major barrier to comprehension for many patients. The objective of this study was to assess the readability of different templates of informed consent forms (ICFs) used in clinical trials in the Center for Research and Training in Skin Diseases and Leprosy (CRTSDL), Tehran, Iran. This study was conducted on ICFs of 45 clinical trials of the CRTSDL affiliated with Tehran University of Medical Sciences. ICFs were tested for reading difficulty, using the readability assessments formula adjusted for the Persian language including the Flesch–Kincaid reading ease score, Flesch–Kincaid grade level, and Gunning fog index. Mean readability score of the whole text of ICFs as well as their 7 main information parts were calculated. The mean ± SD Flesch Reading Ease score for all ICFs was 31.96 ± 5.62 that is in the difficult range. The mean ± SD grade level was calculated as 10.71 ± 1.8 (8.23–14.09) using the Flesch–Kincaid formula and 14.64 ± 1.22 (12.67–18.27) using the Gunning fog index. These results indicate that the text is expected to be understandable for an average student in the 11th grade, while the ethics committee recommend grade level 8 as the standard readability level for ICFs. The results showed that the readability scores of ICFs assessed in our study were not in the acceptable range. This means they were too complex to be understood by the general population. Ethics committees must examine the simplicity and readability of ICFs used in clinical trials. PMID:27471590

  13. Standardized reporting of functioning information on ICF-based common metrics.

    PubMed

    Prodinger, Birgit; Tennant, Alan; Stucki, Gerold

    2018-02-01

    In clinical practice and research a variety of clinical data collection tools are used to collect information on people's functioning for clinical practice and research and national health information systems. Reporting on ICF-based common metrics enables standardized documentation of functioning information in national health information systems. The objective of this methodological note on applying the ICF in rehabilitation is to demonstrate how to report functioning information collected with a data collection tool on ICF-based common metrics. We first specify the requirements for the standardized reporting of functioning information. Secondly, we introduce the methods needed for transforming functioning data to ICF-based common metrics. Finally, we provide an example. The requirements for standardized reporting are as follows: 1) having a common conceptual framework to enable content comparability between any health information; and 2) a measurement framework so that scores between two or more clinical data collection tools can be directly compared. The methods needed to achieve these requirements are the ICF Linking Rules and the Rasch measurement model. Using data collected incorporating the 36-item Short Form Health Survey (SF-36), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and the Stroke Impact Scale 3.0 (SIS 3.0), the application of the standardized reporting based on common metrics is demonstrated. A subset of items from the three tools linked to common chapters of the ICF (d4 Mobility, d5 Self-care and d6 Domestic life), were entered as "super items" into the Rasch model. Good fit was achieved with no residual local dependency and a unidimensional metric. A transformation table allows for comparison between scales, and between a scale and the reporting common metric. Being able to report functioning information collected with commonly used clinical data collection tools with ICF-based common metrics enables clinicians and researchers to continue using their tools while still being able to compare and aggregate the information within and across tools.

  14. [The use of "cognitive" in health terminology. A latent controversy].

    PubMed

    Salvador-Carulla, Luis; Aguilera, Francisco

    2010-10-01

    The adjective «cognitive» has a double meaning and it is used for naming two disciplines with separate activities: Cognitive neuroscience and cognitive psychotherapy. This has an unrecognised impact on the health terminology and the classification systems. The current use of this term is reviewed in a series of key dictionaries, scientific books, databases (OldMedline and PsycINFO) and specific web searchers (Google Scholar). The history of this term and its etymology is also reviewed and compared to other alternatives (i.e. noetic) as well as its use in international classifications (e.g. the International Classification of Functioning - ICF). The modern use of the term «cognitive» in Neurosciences can be traced back to Hebb in a 1955 one year before that recorded at official version. The different meaning of this term in psychology can be traced back to the same decade. Departing from the ICF framework of mental functions, «cognitive» can be regarded as a generic term that encompasses both neurocognitive and meta-cognitive functions and should not be used for classification purposes. A hierarchy is suggested for the use of «neurocognitive» in the classification of mental functions. The polysemic use of this name reveals a latent controversy in health sciences which has implications for its use in the international classification systems. There is an need to improve the standard definition and the semantic hierarchy of the term «cognitive», «neurocognitive» and other related terms within the context of International Health Terminology Standards Development Organisation (IHTSO). Copyright © 2010 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

  15. The HTA core model: a novel method for producing and reporting health technology assessments.

    PubMed

    Lampe, Kristian; Mäkelä, Marjukka; Garrido, Marcial Velasco; Anttila, Heidi; Autti-Rämö, Ilona; Hicks, Nicholas J; Hofmann, Björn; Koivisto, Juha; Kunz, Regina; Kärki, Pia; Malmivaara, Antti; Meiesaar, Kersti; Reiman-Möttönen, Päivi; Norderhaug, Inger; Pasternack, Iris; Ruano-Ravina, Alberto; Räsänen, Pirjo; Saalasti-Koskinen, Ulla; Saarni, Samuli I; Walin, Laura; Kristensen, Finn Børlum

    2009-12-01

    The aim of this study was to develop and test a generic framework to enable international collaboration for producing and sharing results of health technology assessments (HTAs). Ten international teams constructed the HTA Core Model, dividing information contained in a comprehensive HTA into standardized pieces, the assessment elements. Each element contains a generic issue that is translated into practical research questions while performing an assessment. Elements were described in detail in element cards. Two pilot assessments, designated as Core HTAs were also produced. The Model and Core HTAs were both validated. Guidance on the use of the HTA Core Model was compiled into a Handbook. The HTA Core Model considers health technologies through nine domains. Two applications of the Model were developed, one for medical and surgical interventions and another for diagnostic technologies. Two Core HTAs were produced in parallel with developing the model, providing the first real-life testing of the Model and input for further development. The results of formal validation and public feedback were primarily positive. Development needs were also identified and considered. An online Handbook is available. The HTA Core Model is a novel approach to HTA. It enables effective international production and sharing of HTA results in a structured format. The face validity of the Model was confirmed during the project, but further testing and refining are needed to ensure optimal usefulness and user-friendliness. Core HTAs are intended to serve as a basis for local HTA reports. Core HTAs do not contain recommendations on technology use.

  16. Reconsideration of the scheme of the international classification of functioning, disability and health: incentives from the Netherlands for a global debate.

    PubMed

    Heerkens, Yvonne F; de Weerd, Marjolein; Huber, Machteld; de Brouwer, Carin P M; van der Veen, Sabina; Perenboom, Rom J M; van Gool, Coen H; Ten Napel, Huib; van Bon-Martens, Marja; Stallinga, Hillegonda A; van Meeteren, Nico L U

    2018-03-01

    The ICF (International Classification of Functioning, Disability and Health) framework (used worldwide to describe 'functioning' and 'disability'), including the ICF scheme (visualization of functioning as result of interaction with health condition and contextual factors), needs reconsideration. The purpose of this article is to discuss alternative ICF schemes. Reconsideration of ICF via literature review and discussions with 23 Dutch ICF experts. Twenty-six experts were invited to rank the three resulting alternative schemes. The literature review provided five themes: 1) societal developments; 2) health and research influences; 3) conceptualization of health; 4) models/frameworks of health and disability; and 5) ICF-criticism (e.g. position of 'health condition' at the top and role of 'contextual factors'). Experts concluded that the ICF scheme gives the impression that the medical perspective is dominant instead of the biopsychosocial perspective. Three alternative ICF schemes were ranked by 16 (62%) experts, resulting in one preferred scheme. There is a need for a new ICF scheme, better reflecting the ICF framework, for further (inter)national consideration. These Dutch schemes should be reviewed on a global scale, to develop a scheme that is more consistent with current and foreseen developments and changing ideas on health. Implications for Rehabilitation We propose policy makers on community, regional and (inter)national level to consider the use of the alternative schemes of the International Classification of Functioning, Disability and Health within their plans to promote functioning and health of their citizens and researchers and teachers to incorporate the alternative schemes into their research and education to emphasize the biopsychosocial paradigm. We propose to set up an international Delphi procedure involving citizens (including patients), experts in healthcare, occupational care, research, education and policy, and planning to get consensus on an alternative scheme of the International Classification of Functioning, Disability and Health. We recommend to discuss the alternatives for the present scheme of the International Classification of Functioning, Disability and Health in the present update and revision process within the World Health Organization as a part of the discussion on the future of the International Classification of Functioning, Disability and Health framework (including ontology, title and relation with the International Classification of Diseases). We recommend to revise the definition of personal factors and to draft a list of personal factors that can be used in policy making, clinical practice, research, and education and to put effort in the revision of the present list of environmental factors to make it more useful in, e.g., occupational health care.

  17. Promoting and regulating generic medicines: Brazil in comparative perspective.

    PubMed

    da Fonseca, Elize Massard; Shadlen, Kenneth C

    2017-04-20

    Promoting the use of generic drugs can constitute a core instrument for countries' national pharmaceutical policies, one that reduces drug expenditure while expanding health care access. Despite the potential importance of such policy measures and the differences among national practices, scholars embarking on comparative analysis lack a roadmap for determining which dimensions of generic drug policy to assess and compare. This report fills that gap by considering national rules and regulations across four dimensions deemed crucial to any evaluation: demonstrated therapeutic equivalence; pharmaceutical packaging and labeling; drug prescription; and drug substitution. Furthermore, this report examines how the diverse interests of public and private sector stakeholders might shape generic drug policy and its implementation. To illustrate the challenges and conflicts behind policy development and implementation, this report focuses on the case of Brazil.

  18. Choice-making among Medicaid HCBS and ICF/MR recipients in six states.

    PubMed

    Lakin, K Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger; Taub, Sarah; Chiri, Giuseppina

    2008-09-01

    Choice in everyday decisions and in support-related decisions was addressed among 2,398 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services and living in non family settings in six states. Everyday choice in daily life and in support-related choice was considerably higher on average for HCBS than for ICF/MR recipients, but after controlling for level of intellectual disability, medical care needs, mobility, behavioral and psychiatric conditions, and self-reporting, we found that choice was more strongly associated with living in a congregate setting than whether that setting was HCBS- or ICF/MR-financed. Marked differences in choice were also evident between states.

  19. Patient-reported Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales in pediatric patients with attention-deficit/hyperactivity disorder and comorbid psychiatric disorders: feasibility, reliability, and validity.

    PubMed

    Limbers, Christine A; Ripperger-Suhler, Jane; Heffer, Robert W; Varni, James W

    2011-06-01

    The primary objective of the study was to evaluate the feasibility, reliability, and validity of the Pediatric Quality of Life Inventory™ (PedsQL) 4.0 Generic Core Scales as a patient self-reported health-related quality of life measurement instrument in pediatric patients with attention-deficit/hyperactivity disorder (ADHD) and physician-diagnosed comorbid psychiatric disorders being seen in a pediatric psychiatric clinic. The secondary objective was to evaluate parent proxy-reported PedsQL in this population. One hundred seventy-nine children with ADHD and comorbid psychiatric disorders ages 5 to 18 years and 181 parents completed the PedsQL 4.0 Generic Core Scales and parents also completed the Vanderbilt ADHD Diagnostic Rating Scales. Known-groups discriminant validity comparisons were made between the sample of pediatric patients with ADHD and comorbid psychiatric disorders and healthy, cancer, and type 1 diabetes samples. The PedsQL evidenced minimal missing responses for patient self-report and parent proxy-report (0.2% and 0.5%, respectively), demonstrated no significant floor or ceiling effects, and achieved excellent reliability for the Total Scale Score (α = 0.85 patient self-report, 0.92 parent proxy-report). Pediatric patients with ADHD and comorbid psychiatric disorders and their parents reported statistically significantly worse PedsQL scores than healthy children, with large effect sizes across all domains, supporting known-groups discriminant validity. Pediatric patients with ADHD and comorbid psychiatric disorders and their parents reported worse PedsQL scores compared to pediatric patients with cancer and diabetes with the exception of physical health, in which pediatric cancer patients manifested lower physical health, indicating the relative severe impact of ADHD and comorbid psychiatric disorders. More severe ADHD symptoms were generally associated with more impaired PedsQL scores, supporting construct validity. These data demonstrate the feasibility, reliability, and validity of patient self-reported PedsQL 4.0 Generic Core Scales in this high risk population of pediatric patients and highlight the profound negative impact of ADHD and comorbid psychiatric disorders on generic health-related quality of life, comparable to or worse than serious pediatric chronic physical diseases. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. Main steam-line break core shroud loading calculations for BWRs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shoop, U.; Feltus, M.A.; Baratta, A.J.

    1995-12-31

    In July 1994, the U.S. Nuclear regulatory Commission sent out Generic Letter 94-03 to all boiling water reactors in the United States, informing them of intergranular stress corrosion cracking of core shrouds found in 2 reactors. The letter directed all to perform safety analysis of the BWR units. Penn State performed scoping calculations to determine the forces experienced by the core shroud during a main-stream line break transient.

  1. The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: reliability and validity.

    PubMed

    Varni, James W; Burwinkle, Tasha M; Szer, Ilona S

    2004-12-01

    . The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health related quality of life (HRQOL) in children and adolescents ages 2-18 years. The recently developed 18-item PedsQL Multidimensional Fatigue Scale was designed to measure fatigue in pediatric patients and comprises the General Fatigue Scale (6 items), Sleep/Rest Fatigue Scale (6 items), and Cognitive Fatigue Scale (6 items). The PedsQL 4.0 Generic Core Scales were developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 3.0 Rheumatology Module was designed to measure pediatric rheumatology-specific HRQOL. Methods. The PedsQL Multidimensional Fatigue Scale, Generic Core Scales, and Rheumatology Module were administered to 163 children and 154 parents (183 families accrued overall) recruited from a pediatric rheumatology clinic. Results. Internal consistency reliability for the PedsQL Multidimensional Fatigue Scale Total Score (a = 0.95 child, 0.95 parent report), General Fatigue Scale (a = 0.93 child, 0.92 parent), Sleep/Rest Fatigue Scale (a = 0.88 child, 0.90 parent), and Cognitive Fatigue Scale (a = 0.93 child, 0.96 parent) were excellent for group and individual comparisons. The validity of the PedsQL Multidimensional Fatigue Scale was confirmed through hypothesized intercorrelations with dimensions of generic and rheumatology-specific HRQOL. The PedsQL Multidimensional Fatigue Scale distinguished between healthy children and children with rheumatic diseases as a group, and was associated with greater disease severity. Children with fibromyalgia manifested greater fatigue than children with other rheumatic diseases. The results confirm the initial reliability and validity of the PedsQL Multidimensional Fatigue Scale in pediatric rheumatology.

  2. Prevalence and features of ICF-disability in Spain as captured by the 2008 National Disability Survey

    PubMed Central

    2011-01-01

    Background Since 1986, the study of disability in Spain has been mainly addressed by National Disability Surveys (NDSs). While international attempts to frame NDS designs within the International Classification of Functioning, Disability and Health (ICF) have progressed, in general, the ICF has hardly been used in either the NDS or epidemiological studies. This study sought to identify ICF Activity- and Participation-related content in the most recent Spanish NDS, the 2008 Survey on Disabilities, Independence and Dependency Situations (Encuesta sobre discapacidades, autonomía personal y situaciones de Dependencia - EDAD 2008), and estimate the prevalence of such ICF-framed disability. Methods EDAD 2008 methods and questions were perused. Of the 51 EDAD items analysed, 29 were backcoded to specific d2-d7 domains of the ICF Checklist and, by rating the recorded difficulty to perform specific tasks with or without help, these were then taken as performance and capacity respectively. A global ICF score was also derived, albeit lacking data for d1, "Learning and applying knowledge", d8, "Major Life Areas" and d9, "Community, Social and Civic Life". Data were grouped by sex, age, residence and initial positive screening, and prevalence figures were calculated by disability level both for the general population, using the originally designed weights, and for the population that had screened positive to disability. Data for institutionalised persons were processed separately. Results Crude prevalence of ICF severe/complete and moderate disability among the community-dwelling population aged ≥6 years was 0.9%-2.2% respectively, and that of severe/complete disability among persons living in sheltered accommodation was 0.3%. Prevalence of severe/complete disability was: higher in women than in men, 0.8% vs. 0.4%; increased with age; and was particularly high in domains such as "Domestic Life", 3.4%, "Mobility", 1.8%, and "Self-care", 1.9%, in which prevalence decreased when measured by reference to performance. Moreover, global scores indicated that severe/complete disability in these same domains was frequent among the moderately disabled group. Conclusions The EDAD 2008 affords an insufficient data set to be ICF-framed when it comes to the Activity and Participation domains. Notwithstanding their unknown validity, ratings for available ICF domains may, however, be suitable for consideration under the ADL model of functional dependency, suggesting that there are approximately 500,000 persons suffering from severe/complete disability and 1,000,000 suffering from moderate disability, with half the latter being severely disabled in domains capable of benefiting from technical or personal aid. Application of EDAD data to the planning of services for regions and other subpopulations means that need for personal help must be assessed, unmet needs ascertained, and knowledge of social participation and support, particularly for the mentally ill, improved. International, WHO-supported co-operation in ICF planning and use of NDSs in Spain and other countries is needed. PMID:22122806

  3. [Patient orientation and reference to the ICF as challenges in outcome assessment in rehabilitation].

    PubMed

    Farin, E

    2008-04-01

    Measuring the results of rehabilitation interventions presents a number of issues regarding content and method, two of which have been selected for discussion in view of the findings of current research--the significance of patient orientation and the relation to the International Classification of Functioning, Disability and Health, ICF. Compilation of patients' treatment goals, expectations and preferences, patient participation in the development of assessment instruments, compilation of patients' evaluations of treatment results and consideration of the subjectivity of the physician as well as interaction between patient and physician were discussed with respect to involving patients in measuring results. The ICF is a terminology system presenting a uniform international classification for describing health conditions that could assume the function of a common language for the members of various occupations involved in medical rehabilitation. Orienting the measurement of results to the ICF is an obvious next step. This can promote patient orientation, as the categories used by the ICF--in particular for the domains of activities and participation--are formulated in terms relevant to daily routine and are thus pertinent to the patients' lifestyle. The consequences resulting from this overview concern future research needs on the one hand, and on the other hand tips for carrying out a patient-oriented, ICF-based measurement of results. The need for research becomes especially clear regarding the measurement of results based on patient preferences, the determination of the participation relevance perceived by the patient as a criterion for "patient significance" (analogous to "clinical significance"), the integration and weighting of patient and physician assessments of success, the consideration of physicians' subjective concepts and patients' communication preferences, and the design of new, ICF-oriented assessment instruments.

  4. Theoretical and simulation research of hydrodynamic instabilities in inertial-confinement fusion implosions

    NASA Astrophysics Data System (ADS)

    Wang, LiFeng; Ye, WenHua; He, XianTu; Wu, JunFeng; Fan, ZhengFeng; Xue, Chuang; Guo, HongYu; Miao, WenYong; Yuan, YongTeng; Dong, JiaQin; Jia, Guo; Zhang, Jing; Li, YingJun; Liu, Jie; Wang, Min; Ding, YongKun; Zhang, WeiYan

    2017-05-01

    Inertial fusion energy (IFE) has been considered a promising, nearly inexhaustible source of sustainable carbon-free power for the world's energy future. It has long been recognized that the control of hydrodynamic instabilities is of critical importance for ignition and high-gain in the inertial-confinement fusion (ICF) hot-spot ignition scheme. In this mini-review, we summarize the progress of theoretical and simulation research of hydrodynamic instabilities in the ICF central hot-spot implosion in our group over the past decade. In order to obtain sufficient understanding of the growth of hydrodynamic instabilities in ICF, we first decompose the problem into different stages according to the implosion physics processes. The decomposed essential physics pro- cesses that are associated with ICF implosions, such as Rayleigh-Taylor instability (RTI), Richtmyer-Meshkov instability (RMI), Kelvin-Helmholtz instability (KHI), convergent geometry effects, as well as perturbation feed-through are reviewed. Analyti- cal models in planar, cylindrical, and spherical geometries have been established to study different physical aspects, including density-gradient, interface-coupling, geometry, and convergent effects. The influence of ablation in the presence of preheating on the RTI has been extensively studied by numerical simulations. The KHI considering the ablation effect has been discussed in detail for the first time. A series of single-mode ablative RTI experiments has been performed on the Shenguang-II laser facility. The theoretical and simulation research provides us the physical insights of linear and weakly nonlinear growths, and nonlinear evolutions of the hydrodynamic instabilities in ICF implosions, which has directly supported the research of ICF ignition target design. The ICF hot-spot ignition implosion design that uses several controlling features, based on our current understanding of hydrodynamic instabilities, to address shell implosion stability, has been briefly described, several of which are novel.

  5. [ICF-Checklist to Evaluate Inclusion of Elderlies with Intellectual Disability - Psychometric Properties].

    PubMed

    Queri, Silvia; Eggart, Michael; Wendel, Maren; Peter, Ulrike

    2017-11-28

    Background An instrument should have been developed to measure participation as one possible criterion to evaluate inclusion of elderly people with intellectual disability. The ICF was utilized, because participation is one part of health related functioning, respectively disability. Furthermore ICF includes environmental factors (contextual factors) and attaches them an essentially influence on health related functioning, in particular on participation. Thus ICF Checklist additionally identifies environmental barriers for elimination. Methodology A linking process with VINELAND-II yielded 138 ICF items for the Checklist. The sample consists of 50 persons with a light or moderate intellectual disability. Two-thirds are female and the average age is 68. They were directly asked about their perceived quality of life. Additionally, proxy interviews were carried out with responsible staff members concerning necessary support and behavioral deviances. The ICF Checklist was administered twice, once (t2) the current staff member should rate health related functioning at the given time and in addition, a staff member who knows the person at least 10 years before (t1) should rate the former functioning. Content validity was investigated with factor analysis and criterion validity with correlational analysis related to supports need, behavioral deviances and perceived quality of life. Quantitative analysis was validated by qualitative content analysis of patient documentation. Results Factor analysis shows logical variable clusters across the extracted factors but neither interpretable factors. The Checklist is reliable, valid related to the chosen criterions and shows the expected age-related shifts. Qualitative analysis corresponds with quantitative data. Consequences/Conclusion ICF Checklist is appropriate to manage and evaluate patient-centered care. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Effects of electron-ion temperature equilibration on inertial confinement fusion implosions.

    PubMed

    Xu, Barry; Hu, S X

    2011-07-01

    The electron-ion temperature relaxation essentially affects both the laser absorption in coronal plasmas and the hot-spot formation in inertial confinement fusion (ICF). It has recently been reexamined for plasma conditions closely relevant to ICF implosions using either classical molecular-dynamics simulations or analytical methods. To explore the electron-ion temperature equilibration effects on ICF implosion performance, we have examined two Coulomb logarithm models by implementing them into our hydrocodes, and we have carried out hydrosimulations for ICF implosions. Compared to the Lee-More model that is currently used in our standard hydrocodes, the two models predict substantial differences in laser absorption, coronal temperatures, and neutron yields for ICF implosions at the OMEGA Laser Facility [Boehly et al. Opt. Commun. 133, 495 (1997)]. Such effects on the triple-picket direct-drive design at the National Ignition Facility (NIF) have also been explored. Based on the validity of the two models, we have proposed a combined model of the electron-ion temperature-relaxation rate for the overall ICF plasma conditions. The hydrosimulations using the combined model for OMEGA implosions have shown ∼6% more laser absorption, ∼6%-15% higher coronal temperatures, and ∼10% more neutron yield, when compared to the Lee-More model prediction. It is also noticed that the gain for the NIF direct-drive design can be varied by ∼10% among the different electron-ion temperature-relaxation models.

  7. Growth impairment due to transient hypercortisolism.

    PubMed

    Armour, K; Chalew, S; Kowarski, A A

    1986-01-01

    Cushing's syndrome in childhood is generally recognized by classical features such as truncal obesity, striae, easy bruising, moon facies, hypertension and growth retardation. Exceptionally, Cushing's syndrome has been reported to present as growth failure alone. We diagnosed transient hypercortisolism in 6 children who had poor growth as their only presenting abnormality. The 6 children all had integrated concentrations of cortisols (IC-F) (14.1 +/- 1.7 micrograms/dl; mean +/- 1 SD) which exceeded the IC-F in healthy children and adults (5.7 +/- 1.5 micrograms/dl; P less than 0.001). The IC-F of these 6 index cases overlapped the range of IC-F in patients with pathologically proven Cushing's syndrome (20.2 +/- 4.7 micrograms/dl). Four of the 6 patients were treated with human growth hormone for 8 months and showed a marked improvement in their growth rates. Four patients have entered puberty and are growing at normal rates. Three of the 6 children had normal repeat IC-Fs, subsequently, at a time they had normal growth rates. In 1-1/2 to 3 years of follow-up, none of the patients developed any other stigmata of Cushing's syndrome. We conclude that transient hypercortisolism, documented by the IC-F, may cause growth failure without other symptoms of Cushing's syndrome. Growth hormone therapy may improve the growth rate of these children at the time of their poor growth.

  8. A new informed consent form model for cancer patients: preliminary results of a prospective study by the Italian Association of Medical Oncology (AIOM).

    PubMed

    Gori, Stefania; Greco, Maria Teresa; Catania, Chiara; Colombo, Cinzia; Apolone, Giovanni; Zagonel, Vittorina

    2012-05-01

    To document the preliminary validity of a new informed consent form (ICF) model in terms of face/content validity and feasibility, to collect patients' and oncologists' opinions on it, and to explore physicians' and patients' "knowledge", "opinions" about "the information exchanged". The working group for informed consent promoted by the Italian Association of Medical Oncology developed a new ICF model which was tested in ten Italian cancer centers. Patients and physicians received questionnaires on the new ICF model. Twenty-six independent oncologists were interviewed to collect their opinions. Seventy eight cancer patients were enrolled: about 90% reported having received information about diagnosis and therapy and 80% about prognosis. About 63% of oncologists had no difficulty in administering the ICF. Oncologists used "correct terms" about diagnosis in 92% of patients with localized disease and in 90% with metastasis and about therapy in respectively 75.7% and 80%. About prognosis, oncologists used "vague" and "no information-no pertinent terms" in 79% of patients with localized disease and 92.5% of patients with metastasis. The ICF seemed to have sufficient validity and feasibility. This ICF model could mean that patients require oncologists to spend more time explaining the diagnosis, prognosis and treatment, increasing patient's opportunities to participate actively in the care process. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

  9. The ICF-CY and Goal Attainment Scaling: benefits of their combined use for pediatric practice.

    PubMed

    McDougall, Janette; Wright, Virginia

    2009-01-01

    There is much heterogeneity and disconnect in the approaches used by service providers to conduct needs assessments, set goals and evaluate outcomes for clients receiving pediatric rehabilitation services. The purpose of this article is to describe how the International Classification of Functioning, Disability and Health-Child and Youth (ICF-CY) can be used in combination with Goal Attainment Scaling (GAS), an individualised measure of change, to connect the various phases of the therapeutic process to provide consistent clinical care that is family-centred, collaborative, well directed and accountable. A brief description of both the ICF-CY and GAS as they pertain to pediatric rehabilitation is provided as background. An explanation is given of how the ICF-CY offers a framework through which clients, families and service providers can together identify the areas of clients' needs. In addition, the article discusses how the use of GAS facilitates translation of clients' identified needs into distinct, measurable goals set collaboratively by clients, their families and service providers. Examples of integrated GAS goals set for the various components of the ICF-CY are provided. The utility of GAS as a measure of clinical outcomes for individual clients is also discussed. Used in combination, the ICF-CY and GAS can serve to coordinate, simplify and standardise assessment and outcome evaluation practices for individual clients receiving pediatric rehabilitation services.

  10. Observed side feeding in incomplete fusion dynamics in 16O + 160Gd reaction at energy ∼5.6 MeV/A: Spin distribution measurements

    NASA Astrophysics Data System (ADS)

    Ali, Rahbar; Afzal Ansari, M.; Singh, D.; Kumar, Rakesh; Singh, D. P.; Sharma, M. K.; Gupta, Unnati; Singh, B. P.; Shidling, P. D.; Negi, Dinesh; Muralithar, S.; Singh, R. P.; Bhowmik, R. K.

    2017-12-01

    Spin distributions of various residues populated via complete fusion (CF) and incomplete fusion (ICF) reactions in the interaction of 16O with 160Gd at the projectile energy Eproj ∼ 5.6 MeV/A have been studied. The experimentally measured spin distributions of the residues associated with the ICF reactions are found to be distinctly different from those populated via the CF reactions. An attempt has been made to extract the side-feeding pattern from the spin distributions of CF and ICF reaction products. It has been observed that the CF products are strongly fed over a broad spin range. But, no side-feeding takes place in the low observed spins as low partial waves are strongly hindered in the fast α-emission channels (associated with ICF) in the forward direction. It has also been observed that the mean input angular momentum for direct α-emitting (ICF) channels is relatively higher than evaporation α-emitting (CF) channels, and it increases with direct α-multiplicity in forward direction.

  11. Quality of life of persons with severe mental illness living in an intermediate care facility.

    PubMed

    Anderson, R L; Lewis, D A

    2000-04-01

    This study examined resident characteristics, clinical factors, and mental health service utilization associated with quality of life (QOL) for residents living in an Intermediate Care Facility (ICF). This study also utilized published literature to compare the QOL of ICF residents to persons with psychiatric disorders living in other residential settings. Chart review and interviews were used to study 100 randomly selected residents living in an ICF with a chart diagnosis of schizophrenia. Multivariate analyses suggest that higher levels of QOL are associated with reports that psychological problems did not interfere with work and activities and with lower levels of being a danger to others. Also, a comparison of the QOL scores reported by ICF residents to other published mentally ill populations suggests that residents of the ICF report somewhat higher QOL scores than state hospital patients, but lower scores as compared to other community samples. Data provide insight into the types of problems faced by residents of an intermediate care facility. These findings have implications for understanding the importance of mental health service utilization on QOL.

  12. Italian ICF training programs: describing and promoting human functioning and research.

    PubMed

    Francescutti, Carlo; Fusaro, Guido; Leonardi, Matilde; Martinuzzi, Andrea; Sala, Marina; Russo, Emanuela; Frare, Mara; Pradal, Monica; Zampogna, Daniela; Cosentino, Alessandro; Raggi, Alberto

    2009-01-01

    Purpose of the article is to report on 5 years of ICF training experiences in Italy aimed at promoting a consistent approach to ICF's field application. More than 7000 persons participated in around 150 training events: almost half were organised by political bodies, at national, regional or local level, directly linked to implementation experiences. Few training events were organised by the school sector, while training commissioned by NGOs represent a relevant area and, in our opinion, constitute the first step towards a full inclusion of persons with disabilities. Central pillars of our training modules are: the inclusion of all ICF components in the description of functional profiles, the need of providing brief theoretical background information before moving to practical aspects and the importance of providing personalised face to face training modules, in contrast to self-administered learning modules, or web-based protocols. On the basis of our experience, we can conclude that training's objectives are generally reached: trainees improved their knowledge of the ICF and its related tools, and are able to begin practical applications in their contexts.

  13. Plasma viscosity with mass transport in spherical inertial confinement fusion implosion simulations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vold, E. L.; Molvig, K.; Joglekar, A. S.

    2015-11-15

    The effects of viscosity and small-scale atomic-level mixing on plasmas in inertial confinement fusion (ICF) currently represent challenges in ICF research. Many current ICF hydrodynamic codes ignore the effects of viscosity though recent research indicates viscosity and mixing by classical transport processes may have a substantial impact on implosion dynamics. We have implemented a Lagrangian hydrodynamic code in one-dimensional spherical geometry with plasma viscosity and mass transport and including a three temperature model for ions, electrons, and radiation treated in a gray radiation diffusion approximation. The code is used to study ICF implosion differences with and without plasma viscosity andmore » to determine the impacts of viscosity on temperature histories and neutron yield. It was found that plasma viscosity has substantial impacts on ICF shock dynamics characterized by shock burn timing, maximum burn temperatures, convergence ratio, and time history of neutron production rates. Plasma viscosity reduces the need for artificial viscosity to maintain numerical stability in the Lagrangian formulation and also modifies the flux-limiting needed for electron thermal conduction.« less

  14. Plasma viscosity with mass transport in spherical inertial confinement fusion implosion simulations

    DOE PAGES

    Vold, Erik Lehman; Joglekar, Archis S.; Ortega, Mario I.; ...

    2015-11-20

    The effects of viscosity and small-scale atomic-level mixing on plasmas in inertial confinement fusion(ICF) currently represent challenges in ICF research. Many current ICF hydrodynamic codes ignore the effects of viscosity though recent research indicates viscosity and mixing by classical transport processes may have a substantial impact on implosion dynamics. In this paper, we have implemented a Lagrangian hydrodynamic code in one-dimensional spherical geometry with plasmaviscosity and mass transport and including a three temperature model for ions, electrons, and radiation treated in a gray radiation diffusion approximation. The code is used to study ICF implosion differences with and without plasmaviscosity andmore » to determine the impacts of viscosity on temperature histories and neutron yield. It was found that plasmaviscosity has substantial impacts on ICF shock dynamics characterized by shock burn timing, maximum burn temperatures, convergence ratio, and time history of neutron production rates. Finally, plasmaviscosity reduces the need for artificial viscosity to maintain numerical stability in the Lagrangian formulation and also modifies the flux-limiting needed for electron thermal conduction.« less

  15. Psychometric properties of the Swedish PedsQL, Pediatric Quality of Life Inventory 4.0 generic core scales.

    PubMed

    Petersen, Solveig; Hägglöf, Bruno; Stenlund, Hans; Bergström, Erik

    2009-09-01

    To study the psychometric performance of the Swedish version of the Pediatric Quality of Life Inventory (PedsQL) 4.0 generic core scales in a general child population in Sweden. PedsQL forms were distributed to 2403 schoolchildren and 888 parents in two different school settings. Reliability and validity was studied for self-reports and proxy reports, full forms and short forms. Confirmatory factor analysis tested the factor structure and multigroup confirmatory factor analysis tested measurement invariance between boys and girls. Test-retest reliability was demonstrated for all scales and internal consistency reliability was shown with alpha value exceeding 0.70 for all scales but one (self-report short form: social functioning). Child-parent agreement was low to moderate. The four-factor structure of the PedsQL and factorial invariance across sex subgroups were confirmed for the self-report forms and for the proxy short form, while model fit indices suggested improvement of several proxy full-form scales. The Swedish PedsQL 4.0 generic core scales are a reliable and valid tool for health-related quality of life (HRQoL) assessment in Swedish child populations. The proxy full form, however, should be used with caution. The study also support continued use of the PedsQL as a four-factor model, capable of revealing meaningful HRQoL differences between boys and girls.

  16. Factorial invariance of child self-report across healthy and chronic health condition groups: a confirmatory factor analysis utilizing the PedsQLTM 4.0 Generic Core Scales.

    PubMed

    Limbers, Christine A; Newman, Daniel A; Varni, James W

    2008-07-01

    The objective of the present study was to examine the factorial invariance of the PedsQL 4.0 Generic Core Scales for child self-report across 11,433 children ages 5-18 with chronic health conditions and healthy children. Multigroup Confirmatory Factor Analysis was performed specifying a five-factor model. Two multigroup structural equation models, one with constrained parameters and the other with unconstrained parameters, were proposed in order to compare the factor loadings across children with chronic health conditions and healthy children. Metric invariance (i.e., equal factor loadings) was demonstrated based on stability of the Comparative Fit Index (CFI) between the two models, and several additional indices of practical fit including the root mean squared error of approximation, the Non-normed Fit Index, and the Parsimony Normed Fit Index. The findings support an equivalent five-factor structure on the PedsQL 4.0 Generic Core Scales across healthy and chronic health condition groups. These findings suggest that when differences are found across chronic health condition and healthy groups when utilizing the PedsQL, these differences are more likely real differences in self-perceived health-related quality of life, rather than differences in interpretation of the PedsQL items as a function of health status.

  17. TRAC-BF1 thermal-hydraulic, ANSYS stress analysis for core shroud cracking phenomena

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shoop, U.; Feltus, M.A.; Baratta, A.J.

    1996-12-31

    The U.S. Nuclear Regulatory Commission sent Generic Letter 94-03 informing all licensees about the intergranular stress corrosion cracking (IGSCC) of core shrouds found in both Dresden unit I and Quad Cities unit 1. The letter directed all licensees to perform safety analysis of their boiling water reactor (BWR) units. Two transients of special concern for the core shroud safety analysis include the main steam line break (MSLB) and recirculation line break transient.

  18. The Rocket Equation Improvement under ICF Implosion Experiment

    NASA Astrophysics Data System (ADS)

    Wang, Yanbin; Zheng, Zhijian

    2013-10-01

    The ICF explosion process has been studied in details. The rocket equation has been improved in explosive process by introducing the pressure parameter of fuel. Some methods could be drawn by the improved rocket equation. And the methods could be used to improve ICF target design, driving pulse design and experimental design. The First is to increase ablation pressure. The second is to decrease pressure of fuel. The third is to use larger diameter of target sphere. And the forth is to a shorten driving pulse.

  19. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology.

    PubMed

    Gutenbrunner, Christoph; Bender, Tamas; Cantista, Pedro; Karagülle, Zeki

    2010-09-01

    Health Resort Medicine, Balneology, Medical Hydrology and Climatology are not fully recognised as independent medical specialties at a global international level. Analysing the reasons, we can identify both external (from outside the field) and internal (from inside the field) factors. External arguments include, e.g. the lack of scientific evidence, the fact that Balneotherapy and Climatotherapy is not used in all countries, and the fact that Health Resort Medicine, Balneology, Medical Hydrology and Climatology focus only on single methods and do not have a comprehensive concept. Implicit barriers are the lack of international accepted terms in the field, the restriction of being allowed to practice the activities only in specific settings, and the trend to use Balneotherapy mainly for wellness concepts. Especially the implicit barriers should be subject to intense discussions among scientists and specialists. This paper suggests one option to tackle the problem of implicit barriers by making a proposal for a structure and description of the medical field, and to provide some commonly acceptable descriptions of content and terminology. The medical area can be defined as "medicine in health resorts" (or "health resort medicine"). Health resort medicine includes "all medical activities originated and derived in health resorts based on scientific evidence aiming at health promotion, prevention, therapy and rehabilitation". Core elements of health resort interventions in health resorts are balneotherapy, hydrotherapy, and climatotherapy. Health resort medicine can be used for health promotion, prevention, treatment, and rehabilitation. The use of natural mineral waters, gases and peloids in many countries is called balneotherapy, but other (equivalent) terms exist. Substances used for balneotherapy are medical mineral waters, medical peloids, and natural gases (bathing, drinking, inhalation, etc.). The use of plain water (tap water) for therapy is called hydrotherapy, and the use of climatic factors for therapy is called climatotherapy. Reflecting the effects of health resort medicine, it is important to take other environmental factors into account. These can be classified within the framework of the ICF (International Classification of Functioning, Disability and Health). Examples include receiving health care by specialised doctors, being well educated (ICF-domain: e355), having an environment supporting social contacts (family, peer groups) (cf. ICF-domains: d740, d760), facilities for recreation, cultural activities, leisure and sports (cf. ICF-domain: d920), access to a health-promoting atmosphere and an environment close to nature (cf. ICF-domain: e210). The scientific field dealing with health resort medicine is called health resort sciences. It includes the medical sciences, psychology, social sciences, technical sciences, chemistry, physics, geography, jurisprudence, etc. Finally, this paper proposes a systematic international discussion of descriptions in the field of Health Resort Medicine, Balneology, Medical Hydrology and Climatology, and discusses short descriptive terms with the goal of achieving internationally accepted distinct terms. This task should be done via a structured consensus process and is of major importance for the publication of scientific results as well as for systematic reviews and meta-analyses.

  20. Two-dimensional ice mapping of molecular cores

    NASA Astrophysics Data System (ADS)

    Noble, J. A.; Fraser, H. J.; Pontoppidan, K. M.; Craigon, A. M.

    2017-06-01

    We present maps of the column densities of H2O, CO2 and CO ices towards the molecular cores B 35A, DC 274.2-00.4, BHR 59 and DC 300.7-01.0. These ice maps, probing spatial distances in molecular cores as low as 2200 au, challenge the traditional hypothesis that the denser the region observed, the more ice is present, providing evidence that the relationships between solid molecular species are more varied than the generic picture we often adopt to model gas-grain chemical processes and explain feedback between solid phase processes and gas phase abundances. We present the first combined solid-gas maps of a single molecular species, based upon observations of both CO ice and gas phase C18O towards B 35A, a star-forming dense core in Orion. We conclude that molecular species in the solid phase are powerful tracers of 'small-scale' chemical diversity, prior to the onset of star formation. With a component analysis approach, we can probe the solid phase chemistry of a region at a level of detail greater than that provided by statistical analyses or generic conclusions drawn from single pointing line-of-sight observations alone.

  1. 78 FR 50057 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... collection; Title of Information Collection: Intermediate Care Facility (ICF) for the Mentally Retarded (MR... intermediate care facility (ICF) for the mentally retarded (MR) provider and client characteristics are...

  2. Exploring incomplete fusion fraction in 6,7Li induced nuclear reactions

    NASA Astrophysics Data System (ADS)

    Parkar, V. V.; Jha, V.; Kailas, S.

    2017-11-01

    We have included breakup effects explicitly to simultaneously calculate the measured cross-sections of the complete fusion, incomplete fusion, and total fusion for 6,7Li projectiles on various targets using the Continuum Discretized Coupled Channels method. The breakup absorption cross-sections obtained with different choices of short range imaginary potentials are utilized to evaluate the individual α-capture and d/t-capture cross-sections and compare with the measured data. It is interesting to note, while in case of 7Li projectile the cross-sections for triton-ICF/triton-capture is far more dominant than α-ICF/α-capture at all energies, similar behavior is not observed in case of 6Li projectile for the deuteron-ICF/deuteron-capture and α-ICF/α-capture. Both these observations are also corroborated by the experimental data for all the systems studied.

  3. High-Energy-Density-Physics Studies for Inertial Confinement Fusion Applications

    NASA Astrophysics Data System (ADS)

    Hu, S. X.

    2017-10-01

    Accurate knowledge of the static, transport, and optical properties of high-energy-density (HED) plasmas is essential for reliably designing and understanding inertial confinement fusion (ICF) implosions. In the warm-dense-matter regime routinely accessed by low-adiabat ICF implosions, many-body strong-coupling and quantum electron degeneracy effects play an important role in determining plasma properties. The past several years have witnessed intense efforts to assess the importance of the microphysics of ICF targets, both theoretically and experimentally. On the theory side, first-principles methods based on quantum mechanics have been applied to investigate the properties of warm, dense plasmas. Specifically, self-consistent investigations have recently been performed on the equation of state, thermal conductivity, and opacity of a variety of ICF ablators such as polystyrene (CH), beryllium, carbon, and silicon over a wide range of densities and temperatures. In this talk, we will focus on the most-recent progress on these ab initio HED physics studies, which generally result in favorable comparisons with experiments. Upon incorporation into hydrocodes for ICF simulations, these first-principles ablator-plasma properties have produced significant differences over traditional models in predicting 1-D target performance of ICF implosions on OMEGA and direct-drive-ignition designs for the National Ignition Facility. This material is based upon work supported by the Department of Energy National Nuclear Security Administration under Award Number DE-NA0001944. *In collaboration with L. A. Collins, T. R. Boehly, G. W. Collins, J. D. Kress, and V. N. Goncharov.

  4. Content comparison of occupation-based instruments in adult rheumatology and musculoskeletal rehabilitation based on the International Classification of Functioning, Disability and Health.

    PubMed

    Stamm, Tanja A; Cieza, Alarcos; Machold, Klaus P; Smolen, Josef S; Stucki, Gerold

    2004-12-15

    To compare the content of clinical, occupation-based instruments that are used in adult rheumatology and musculoskeletal rehabilitation in occupational therapy based on the International Classification of Functioning, Disability and Health (ICF). Clinical instruments of occupational performance and occupation in adult rehabilitation and rheumatology were identified in a literature search. All items of these instruments were linked to the ICF categories according to 10 linking rules. On the basis of the linking, the content of these instruments was compared and the relationship between the capacity and performance component explored. The following 7 instruments were identified: the Canadian Occupational Performance Measure, the Assessment of Motor and Process Skills, the Sequential Occupational Dexterity Assessment, the Jebson Taylor Hand Function Test, the Moberg Picking Up Test, the Button Test, and the Functional Dexterity Test. The items of the 7 instruments were linked to 53 different ICF categories. Five items could not be linked to the ICF. The areas covered by the 7 occupation-based instruments differ importantly: The main focus of all 7 instruments is on the ICF component activities and participation. Body functions are covered by 2 instruments. Two instruments were linked to 1 single ICF category only. Clinicians and researchers who need to select an occupation-based instrument must be aware of the areas that are covered by this instrument and the potential areas that are not covered at all.

  5. Examining Functioning and Contextual Factors in Individuals with Joint Contractures from the Health Professional Perspective Using the ICF: An International Internet-Based Qualitative Expert Survey.

    PubMed

    Fischer, Uli; Müller, Martin; Strobl, Ralf; Bartoszek, Gabriele; Meyer, Gabriele; Grill, Eva

    2016-01-01

    The aim of this study was to identify disease-related aspects of functioning and disability in people with joint contractures from a health professionals' perspective and to describe the findings, using categories of the International Classification of Functioning, Disability, and Health (ICF). An Internet-based expert survey. We asked international health professionals for typical problems in functioning and important contextual factors of individuals with joint contractures using an Internet-based open-ended questionnaire. All answers were linked to the ICF according to established rules. Absolute and relative frequencies of the linked ICF categories were reported. Eighty experts named 1785 meaning units which could be linked to 256 ICF categories. Among the categories, 24.2% belonged to the component Body Functions, 20.7% to Body Structures, 36.3% to Activities and Participation, and 18.8% to Environmental Factors. Health professionals addressed a large variety of functional problems and multifaceted aspects due to the symptom joint contractures. International health professionals reported a large variety of aspects of functioning and health, which are related to joint contractures. © 2014 Association of Rehabilitation Nurses.

  6. Simulations of inertial confinement fusion driven by a novel synchrotron-radiation-based x-ray igniter

    NASA Astrophysics Data System (ADS)

    Shlyaptsev, Vyacheslav N.; Tatchyn, Roman O.

    2004-01-01

    The advantages and challenges of using a powerful x-ray source for the fast ignition of compressed Inertial Confinement Fusion (ICF) targets have been considered. The requirements for such a source together with the optics to focus the x-rays onto compressed DT cores lead to a conceptual design based on Energy Recovery Linacs (ERLs) and long wigglers to produce x-ray pulses with the appropriate phase space properties. A comparative assessment of the parameters of the igniter system indicates that the technologies for building it, although expensive, are physically achievable. Our x-ray fast ignition (XFI) scheme requires substantially smaller energy for the initiation of nuclear fusion reactions than other methods.

  7. Beam wavefront and farfield control for ICF laser driver

    NASA Astrophysics Data System (ADS)

    Dai, Wanjun; Deng, Wu; Zhang, Xin; Jiang, Xuejun; Zhang, Kun; Zhou, Wei; Zhao, Junpu; Hu, Dongxia

    2010-10-01

    Five main problems of beam wavefront and farfield control in ICF laser driver are synthetically discussed, including control requirements, beam propagation principle, distortions source control, system design and adjustment optimization, active wavefront correction technology. We demonstrate that beam can be propagated well and the divergence angle of the TIL pulses can be improved to less than 60μrad with solving these problems, which meets the requirements of TIL. The results can provide theoretical and experimental support for wavefront and farfield control designing requirements of the next large scale ICF driver.

  8. Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL): reliability and validity.

    PubMed

    Devoogdt, Nele; De Groef, An; Hendrickx, Ad; Damstra, Robert; Christiaansen, Anke; Geraerts, Inge; Vervloesem, Nele; Vergote, Ignace; Van Kampen, Marijke

    2014-05-01

    Patients may develop primary (congenital) or secondary (acquired) lymphedema, causing significant physical and psychosocial problems. To plan treatment for lymphedema and monitor a patient's progress, swelling, and problems in functioning associated with lymphedema development should be assessed at baseline and follow-up. The purpose of this study was to investigate the reliability (test-retest, internal consistency, and measurement variability) and validity (content and construct) of data obtained with the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL). This was a multicenter, cross-sectional study. The Lymph-ICF-LL is a descriptive, evaluative tool containing 28 questions about impairments in function, activity limitations, and participation restrictions in patients with lower limb lymphedema. The questionnaire has 5 domains: physical function, mental function, general tasks/household activities, mobility activities, and life domains/social life. The reliability and validity of the Lymph-ICF-LL were examined in 30 participants with objective lower limb lymphedema. Intraclass correlation coefficients for test-retest reliability ranged from .69 to .94, and Cronbach alpha coefficients for internal consistency ranged from .82 to .97. Measurement variability was acceptable (standard error of measurement=5.9-12.6). Content validity was good because all questions were understandable for 93% of participants, the scoring system (visual analog scale) was clear, and the questionnaire was comprehensive for 90% of participants. Construct validity was good. All hypotheses for assessing convergent validity and divergent validity were accepted. The known-groups validity and responsiveness of the Dutch Lymph-ICF-LL and the cross-cultural validity of the English version of the Lymph-ICF-LL were not investigated. The Lymph-ICF-LL is a Dutch questionnaire with evidence of reliability and validity for assessing impairments in function, activity limitations, and participation restrictions in people with primary or secondary lower limb lymphedema.

  9. Optimization of permanent breast seed implant dosimetry incorporating tissue heterogeneity

    NASA Astrophysics Data System (ADS)

    Mashouf, Shahram

    Seed brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose around brachytherapy sources is based on the AAPM TG43 formalism, which generates the dose in homogeneous water medium. Recently, AAPM task group no. 186 (TG186) emphasized the importance of accounting for heterogeneities. In this work we introduce an analytical dose calculation algorithm in heterogeneous media using CT images. The advantages over other methods are computational efficiency and the ease of integration into clinical use. An Inhomogeneity Correction Factor (ICF) is introduced as the ratio of absorbed dose in tissue to that in water medium. ICF is a function of tissue properties and independent of the source structure. The ICF is extracted using CT images and the absorbed dose in tissue can then be calculated by multiplying the dose as calculated by the TG43 formalism times ICF. To evaluate the methodology, we compared our results with Monte Carlo simulations as well as experiments in phantoms with known density and atomic compositions. The dose distributions obtained through applying ICF to TG43 protocol agreed very well with those of Monte Carlo simulations and experiments in all phantoms. In all cases, the mean relative error was reduced by at least a factor of two when ICF correction factor was applied to the TG43 protocol. In conclusion we have developed a new analytical dose calculation method, which enables personalized dose calculations in heterogeneous media using CT images. The methodology offers several advantages including the use of standard TG43 formalism, fast calculation time and extraction of the ICF parameters directly from Hounsfield Units. The methodology was implemented into our clinical treatment planning system where a cohort of 140 patients were processed to study the clinical benefits of a heterogeneity corrected dose.

  10. Health related quality of life assessment in Pakistani paediatric cancer patients using PedsQL™ 4.0 generic core scale and PedsQL™ cancer module.

    PubMed

    Chaudhry, Zainab; Siddiqui, Salma

    2012-05-18

    The purpose of the study was to evaluate and compare the HRQOL of paediatric cancer in comparison to the healthy children across age groups, using PedsQLTM 4.0 Generic Core Scales and the PedsQL™ Cancer Module. The PedsQLTM 4.0 Generic Core Scales and PedsQL Cancer Module 3.0 were administered on 56 children including 26 cancer patients and 30 healthy children while employing self and proxy report forms. Furthermore, the results were compared with their healthy comparison group. The results indicated a significant relationship between HRQOL reports of cancer patients and their parents. However, the mean of paediatric cancer patients is significantly lower as compare to their healthy comparison group. The mean of proxy report is lower overall on both PedsQL and PedsQL cancer module reports. Conclusively, overall HRQOL of cancer patients was lower than healthy children but it is quite similar to their parents' perception. Whereas, the parental mean on PedsQL and PedsQL 3.0 Cancer Module are significantly low. The study indicated a marked difference between cancer patients and healthy children's HRQOL perception and unfortunately in country like Pakistan where cancer is on increase, no significant work has yet been done to explore this area of research. The present study highlighted the need to focus on the particular psychological health services required to serve the physically challenged population.

  11. The Generic Short Patient Experiences Questionnaire (GS-PEQ): identification of core items from a survey in Norway

    PubMed Central

    2011-01-01

    Background Questionnaires are commonly used to collect patient, or user, experiences with health care encounters; however, their adaption to specific target groups limits comparison between groups. We present the construction of a generic questionnaire (maximum of ten questions) for user evaluation across a range of health care services. Methods Based on previous testing of six group-specific questionnaires, we first constructed a generic questionnaire with 23 items related to user experiences. All questions included a "not applicable" response option, as well as a follow-up question about the item's importance. Nine user groups from one health trust were surveyed. Seven groups received questionnaires by mail and two by personal distribution. Selection of core questions was based on three criteria: applicability (proportion "not applicable"), importance (mean scores on follow-up questions), and comprehensiveness (content coverage, maximum two items per dimension). Results 1324 questionnaires were returned providing subsample sizes ranging from 52 to 323. Ten questions were excluded because the proportion of "not applicable" responses exceeded 20% in at least one user group. The number of remaining items was reduced to ten by applying the two other criteria. The final short questionnaire included items on outcome (2), clinician services (2), user involvement (2), incorrect treatment (1), information (1), organisation (1), and accessibility (1). Conclusion The Generic Short Patient Experiences Questionnaire (GS-PEQ) is a short, generic set of questions on user experiences with specialist health care that covers important topics for a range of groups. It can be used alone or with other instruments in quality assessment or in research. The psychometric properties and the relevance of the GS-PEQ in other health care settings and countries need further evaluation. PMID:21510871

  12. Families' perception of children / adolescents with language impairment through the International Classification of Functioning, Disability, and Health (ICF-CY).

    PubMed

    Ostroschi, Daniele Theodoro; Zanolli, Maria de Lurdes; Chun, Regina Yu Shon

    2017-05-22

    To investigate the perception of family members regarding linguistic conditions and social participation of children and adolescents with speech and language impairments using the International Classification of Functioning, Disability and Health - Children and Youth Version (ICF-CY). Quali-quantitative approach research, in which a survey of medical records of 24 children/adolescents undergoing speech-language therapy and interviews with their family members was conducted. A descriptive analysis of the participants' profiles was performed, followed by a categorization of responses using the ICF-CY. All family members mentioned various aspects of speech/language categorized by the ICF-CY. Initially, they approached it as an organic issue, categorized under the component of Body Functions and Structures. Most reported different repercussions of the speech-language impairments on the domains, such as dealing with stress and speaking, qualified from mild to severe. Participants reported Environmental Factors categorized as facilitators in the immediate family's attitudes and as barriers in the social attitudes. These findings, according to the use of the ICF-CY, demonstrate that the children/adolescents' speech-language impairments, from the families' perception, are primarily understood in the body dimension. However, guided by a broader approach to health, the findings in the Activities and Participation and Environmental Factors demonstrate a broader understanding of the participants of the speech-language impairments. The results corroborate the importance of using the ICF-CY as a health care analysis tool, by incorporating functionality and participation aspects and providing subsidies for the construction of unique therapeutic projects in a broader approach to the health of the group studied.

  13. Outcome measures in older persons with acquired joint contractures: a systematic review and content analysis using the ICF (International Classification of Functioning, Disability and Health) as a reference.

    PubMed

    Bartoszek, Gabriele; Fischer, Uli; Müller, Martin; Strobl, Ralf; Grill, Eva; Nadolny, Stephan; Meyer, Gabriele

    2016-02-09

    Joint contractures are a common health problem in older persons with significant impact on activities of daily living. We aimed to retrieve outcome measures applied in studies on older persons with joint contractures and to identify and categorise the concepts contained in these outcome measures using the ICF (International Classification of Functioning, Disability and Health) as a reference. Electronic searches of Medline, EMBASE, CINAHL, Pedro and the Cochrane Library were conducted (1/2002-8/2012). We included studies in the geriatric rehabilitation and nursing home settings with participants aged ≥ 65 years and with acquired joint contractures. Two independent reviewers extracted the outcome measures and transferred them to concepts using predefined conceptual frameworks. Concepts were subsequently linked to the ICF categories. From the 1057 abstracts retrieved, 60 studies met the inclusion criteria. We identified 52 single outcome measures and 24 standardised assessment instruments. A total of 1353 concepts were revealed from the outcome measures; 96.2% could be linked to 50 ICF categories in the 2nd level; 3.8% were not categorised. Fourteen of the 50 categories (28%) belonged to the component Body Functions, 4 (8%) to the component Body Structures, 26 (52%) to the component Activities and Participation, and 6 (12%) to the component Environmental Factors. The ICF is a valuable reference for identifying and quantifying the concepts of outcome measures on joint contractures in older people. The revealed ICF categories remain to be validated in populations with joint contractures in terms of clinical relevance and personal impact.

  14. Review Article: Mapping of children's health and development data on population level using the classification system ICF-CY.

    PubMed

    Ståhl, Ylva; Granlund, Mats; Gäre-Andersson, Boel; Enskär, Karin

    2011-02-01

    The aim of this study was to investigate if essential health and development data of all children in Sweden in the Child Health Service (CHS) and School Health Service (SHS) can be linked to the classification system International Classification of Functioning, Disability and Health--Children and Youth (ICF-CY). Lists of essential health terms, compiled by professionals from CHS and SHS, expected to be used in the national standardised records form the basis for the analysis in this study. The essential health terms have been linked to the codes of ICF-CY by using linking rules and a verification procedure. After exclusion of terms not directly describing children's health, a majority of the health terms could be linked into the ICF-CY with a high proportion of terms in body functions and a lower proportion in activity/participation and environment respectively. Some health terms had broad description and were linked to several ICF-CY codes. The precision of the health terms was at a medium level of detail. ICF-CY can be useful as a tool for documenting child health. It provides not only a code useful for statistical purposes but also a language useful for the CHS and SHS in their work on individual as well as population levels. It was noted that the health terms used by services mainly focused on health related to body function. This indicates that more focus is needed on health data related to child's functioning in everyday life situations.

  15. Modified preauricular approach and rigid internal fixation for intracapsular condyle fracture of the mandible.

    PubMed

    He, Dongmei; Yang, Chi; Chen, Minjie; Bin, Jiang; Zhang, Xiaohu; Qiu, Yating

    2010-07-01

    This article reports a modified preauricular approach for intracapsular condyle fracture (ICF) of the mandible and evaluates the stability of various internal fixation methods in the temporomandibular joint (TMJ) division of the Shanghai Ninth People's Hospital. One hundred fifty-one patients with 208 ICFs diagnosed by panoramic radiograph and computed tomographic (CT) scan received open treatment in the TMJ division from 1999 to 2008. Their charts were reviewed. Classification of the fracture was based on coronal CT scan. Forty-three patients also underwent magnetic resonance imaging before the operation to check displacement of the disc. A modified preauricular approach was used for all patients. Various internal fixation methods from wire, to screw, to plate were evaluated for stability. There were 110 ICFs of type A fracture, 60 of type B fracture, 9 of type C fracture, 25 of type M fracture, and 4 fractures without displacement. A modified preauricular approach was used for open treatment, which can better expose and protect the TMJ and superficial temporal vessels. Wire and plate is the commonly used stable fixation method for type A, B, and M fractures, which accounted for 56.7% (101/178). Small fracture fragments were removed with disc repositioning for all type C fractures (n = 9) and some type B (n = 9) and M fractures (n = 5). Three type M fracture and 3 nondisplaced ICFs were treated closed. Eighty-nine patients with 115 ICFs had postoperative CT scan, which showed anatomic and nearly anatomic fracture reduction rates of 95.6%. Thirty-five patients with 44 ICFs had long-term follow-ups from 3 months to 5 years. Among them, 63.2% (n = 12/19) pediatric ICFs had continuous condyle growth after open reduction and rigid fixation; 92% adults had ICFs that healed well (n = 23/25). Postoperative complications were facial nerve injury (n = 3), TMJ clicking (n = 1), and condyle resorption that required plate removal (n = 4). A modified preauricular approach provides better exposure and protection of the TMJ and superficial temporal vessels. Wire and plate provides stable fixation for type A and some type B and M fractures. Open reduction and rigid fixation produce good results for adult patients. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Rehabilitation interventions in multiple sclerosis: an overview.

    PubMed

    Beer, Serafin; Khan, Fary; Kesselring, Jürg

    2012-09-01

    Multiple sclerosis is a complex, heterogeneous disease associated with long-term disability. Despite the availability of advanced disease-modifying and symptomatic therapies that may decrease activity and progression of disease and alleviate complaints to a certain extent, there is still a need for comprehensive rehabilitation interventions in order to reduce sequels and symptoms of the disease on personal activities and social participation to achieve the highest possible independence and the best quality of life. Timing and setting of rehabilitation interventions should be selected individually depending on disease phase, functional deficits, personal requirements, as well as specific goals. In addition, limitations and disease-specific characteristics that may influence rehabilitation outcome should be noted. Rehabilitation interventions should be considered early for maintaining functional capacity and reducing risk for losing important abilities or independence. Due to gradual failure of adaptive compensatory mechanisms along the course of disease, benefits of rehabilitation interventions are generally higher in earlier phases of MS. Inpatient and outpatient multidisciplinary rehabilitation has been shown to be beneficial in improving disability, participation and quality of life despite progression of the disease. Good evidence exists for different specific interventions improving physical and cognitive performance. Other important issues responsible for beneficial effects of comprehensive rehabilitation in MS include education, instruction, and information of patients and caregivers. Comprehensive assessment of health domains in MS patients using standardized framework and common language for describing the impact of disease at different levels, using International Classification of Functioning, Disability and Health (ICF) core sets may increase the knowledge of needs of these patients for more efficient and adapted rehabilitation interventions meeting these individual requirements, and promote perception and acceptance of rehabilitation as a valuable treatment option in MS. ICF core sets may increase the knowledge of more efficient and adapted rehabilitation measures meeting more properly individual requirements, and promote perception and acceptance of rehabilitation as a valuable treatment option in MS.

  17. Three-dimensional modeling of the neutron spectrum to infer plasma conditions in cryogenic inertial confinement fusion implosions

    NASA Astrophysics Data System (ADS)

    Weilacher, F.; Radha, P. B.; Forrest, C.

    2018-04-01

    Neutron-based diagnostics are typically used to infer compressed core conditions such as areal density and ion temperature in deuterium-tritium (D-T) inertial confinement fusion (ICF) implosions. Asymmetries in the observed neutron-related quantities are important to understanding failure modes in these implosions. Neutrons from fusion reactions and their subsequent interactions including elastic scattering and neutron-induced deuteron breakup reactions are tracked to create spectra. It is shown that background subtraction is important for inferring areal density from backscattered neutrons and is less important for the forward-scattered neutrons. A three-dimensional hydrodynamic simulation of a cryogenic implosion on the OMEGA Laser System [Boehly et al., Opt. Commun. 133, 495 (1997)] using the hydrodynamic code HYDRA [Marinak et al., Phys. Plasmas 8, 2275 (2001)] is post-processed using the tracking code IRIS3D. It is shown that different parts of the neutron spectrum from the view can be mapped into different regions of the implosion, enabling an inference of an areal-density map. It is also shown that the average areal-density and an areal-density map of the compressed target can be reconstructed with a finite number of detectors placed around the target chamber. Ion temperatures are inferred from the width of the D-D and D-T fusion neutron spectra. Backgrounds can significantly alter the inferred ion temperatures from the D-D reaction, whereas they insignificantly influence the inferred D-T ion temperatures for the areal densities typical of OMEGA implosions. Asymmetries resulting in fluid flow in the core are shown to influence the absolute inferred ion temperatures from both reactions, although relative inferred values continue to reflect the underlying asymmetry pattern. The work presented here is part of the wide range of the first set of studies performed with IRIS3D. This code will continue to be used for post-processing detailed hydrodynamic simulations and interpreting observed neutron spectra in ICF implosions.

  18. Medicare: Comparison of Catastropic Health Insurance Proposals--an Update.

    DTIC Science & Technology

    1987-10-01

    Accounting Office ICF intermediate care facility SNF skilled nursing facility VA Veterans Administration d4 ....... ’. - --- MEDICARE: COMPARISON OF...optional woe services, such as home and community-based services; services in an intermediate care facility (ICF); and prescribed drugs, dentures

  19. Medicare: Comparison of Catastrophic Health Insurance Proposals.

    DTIC Science & Technology

    1987-06-01

    GAO General Accounting Office ICF intermediate care facility SNF skilled nursing facility VA Veterans Administration -4 MEDICARE: COMPARISON OF...community-based services; services in an intermediate care facility (ICF); and prescribed drugs, dentures, and eyeglasses. In recent years, the number of

  20. Young adults with intellectual disability transitioning from school to post-school: a literature review framed within the ICF.

    PubMed

    Foley, K-R; Dyke, P; Girdler, S; Bourke, J; Leonard, H

    2012-01-01

    The purpose of this review was to describe literature relating to transition for young people with an intellectual disability and identify gaps within the current knowledge base. A narrative literature review was undertaken. Searches of databases Medline, CINAHL, PsycINFO, ERIC, ISI Web of Science and ProQuest 500 International provided relevant research articles. The search terms used were intellectual disability, transition, employment, and ICF as well as other terms derived from the ICF. Manual searches of reference lists identified additional studies. Furthermore, government websites were searched for relevant reports and policies. Transition literature was explored by ICF domains; body functions and structures, activity and participation and contextual factors. Studies were identified in some but not all areas and included literature describing self-determination and participation in leisure activities for those with mild intellectual disability. However, significant gaps were found particularly for those with severe intellectual disability. The ICF is a useful tool in framing a review of transition literature for young people with intellectual disability due to the complexity and multi-faceted nature of transition. The important influence of environmental factors including family systems, post-school services and access to transport were highlighted as having considerable impacts on transition outcomes.

  1. A simplified analytical dose calculation algorithm accounting for tissue heterogeneity for low-energy brachytherapy sources.

    PubMed

    Mashouf, Shahram; Lechtman, Eli; Beaulieu, Luc; Verhaegen, Frank; Keller, Brian M; Ravi, Ananth; Pignol, Jean-Philippe

    2013-09-21

    The American Association of Physicists in Medicine Task Group No. 43 (AAPM TG-43) formalism is the standard for seeds brachytherapy dose calculation. But for breast seed implants, Monte Carlo simulations reveal large errors due to tissue heterogeneity. Since TG-43 includes several factors to account for source geometry, anisotropy and strength, we propose an additional correction factor, called the inhomogeneity correction factor (ICF), accounting for tissue heterogeneity for Pd-103 brachytherapy. This correction factor is calculated as a function of the media linear attenuation coefficient and mass energy absorption coefficient, and it is independent of the source internal structure. Ultimately the dose in heterogeneous media can be calculated as a product of dose in water as calculated by TG-43 protocol times the ICF. To validate the ICF methodology, dose absorbed in spherical phantoms with large tissue heterogeneities was compared using the TG-43 formalism corrected for heterogeneity versus Monte Carlo simulations. The agreement between Monte Carlo simulations and the ICF method remained within 5% in soft tissues up to several centimeters from a Pd-103 source. Compared to Monte Carlo, the ICF methods can easily be integrated into a clinical treatment planning system and it does not require the detailed internal structure of the source or the photon phase-space.

  2. The multicenter benchmarking study of burn injury: A content analysis of the outcome measures using the international classification of functioning, disability and health.

    PubMed

    Osborne, Candice L; Petersson, Christina; Graham, James E; Meyer, Walter J; Simeonsson, Rune J; Suman, Oscar E; Ottenbacher, Kenneth J

    2016-11-01

    To link, classify and describe the content of the Multicenter Benchmarking Study Burn Outcomes Questionnaires (BOQ) using the International Classification of Functioning, Disability and Health (ICF) to determine if the information garnered provides researchers with the data necessary to develop a comprehensive understanding of life after burns. Two ICF linking experts used a standardized linking technique endorsed by the World Health Organization to link all BOQ concepts to the ICF. Linking results were analyzed to determine the comprehensiveness of each of the five measures. The activities and participation component was most frequently addressed followed by the body functions component. Environmental factors are not extensively covered and body structures are not addressed. ICF chapter and category distribution were skewed and varied between assessments. The majority of BOQ items are of the health status perspective. BOQ item composition could be improved with a more even distribution of pertinent ICF topics. Assessment authors may consider addressing the impact of environmental factors on participation. Including body structure concepts would allow investigators to track structural deformation and/or developmental delay. Generally speaking, this data should not be used to examine quality of life outcomes. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  3. Computer-assisted virtual technology in intracapsular condylar fracture with two resorbable long-screws.

    PubMed

    Wang, W H; Deng, J Y; Zhu, J; Li, M; Xia, B; Xu, B

    2013-03-01

    Our aim was to fix intracapsular condylar fractures (ICF) with two resorbable long screws using preoperative computer-assisted virtual technology. From February 2008 to July 2011, 19 patients with ICF were treated with two resorbable long screws. Preoperatively we took panoramic radiographs and spiral computed tomography (CT). Depending on their digital imaging and communications in medicine (DICOM) data, the dislocated condylar segments were restored using the SimPlant Pro™ software, version 11.04. The mean (SD) widths of the condylar head and neck from lateral to medial were 19.01 (1.28)mm and 13.84 (1.13)mm, respectively. In all patients, the mandibles and the ICF seen intraoperatively corresponded with the preoperative three-dimensional and virtual reposition. All patients were followed up for 6-46 months (mean 21). Occlusion and mouth opening had been restored completely in all but one patient, and absolute anatomical reduction was also achieved in most cases. Computer-assisted virtual technology plays an important part in the diagnosis of ICF, as well as in its preoperative design. Fixation with only two resorbable long screws is an effective and reliable method for fixing ICF. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Psychometric properties of the Sinhala version of the PedsQL™ 4.0 Generic Core Scales in early adolescents in Sri Lanka.

    PubMed

    Danansuriya, Manjula Nishanthi; Rajapaksa, Lalini C

    2012-09-04

    The concept Health related Quality of life (HRQOL) is increasingly recognized as an important health outcome measure in clinical and research fields. The present study attempted to evaluate the psychometric properties of the Sinhala version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales among adolescents in Sri Lanka. The original US PedsQL™ was translated into Sinhala and conceptually validated according to international guidelines. A cross-sectional study was conducted among 142 healthy school going adolescents (12-14 years), their parents (n = 120) and a group of adolescents with asthma who attended asthma clinics (n = 115). Reliability was assessed using Cronbach's alpha and validity by examining scale structure, exploring inter-scale correlations and comparing across known groups (healthy vs. chronically ill). The PedsQL™ Sinhala version was found to be acceptable with minimal missing responses. All scales demonstrated satisfactory reliability. Cronbach's alpha for the total scale scores was 0.85 for adolescent self-report while for the parent proxy-report for the healthy group it was 0.86. No floor effects were observed. Ceiling effects were noticed in self-report and parent proxy-report for the healthy group. Overall results of the multi trait scaling analysis confirmed the scale structure with 74% item-convergent validity, 88% item-discriminant validity and an overall scaling success of 72%. Moderate to high correlations were shown among the domains of teen self-report (Spearman rho = .37-.54) and between teen self-report and parent proxy-reports (Spearman rho = .41-.57). The PedsQL™ tool was able to discriminate between the quality of life in healthy adolescents and adolescents with asthma. The findings support the reliability and validity of the Sinhala version of the PedsQL™ 4.0 Generic Core Scales as a generic instrument to measure HRQOL among early adolescents in Sri Lanka in a population setting.

  5. Do Open Reduction and Internal Fixation With Articular Disc Anatomical Reduction and Rigid Anchorage Manifest a Promising Prospect in the Treatment of Intracapsular Fractures?

    PubMed

    Cai, Bo-Lei; Ren, Rong; Yu, Hong-Bo; Liu, Peng-Chao; Shen, Steve G F; Shi, Jun

    2018-05-01

    In response to the increased attention to soft tissue reduction in the treatment of intracapsular condylar fractures (ICFs), a modified open reduction technique is proposed and its functional and radiographic outcomes were evaluated in this study. This is a retrospective case series study of patients with all ICF types that were treated with open reduction and internal fixation (ORIF) with articular disc anatomic reduction and rigid anchorage. Inclusion and exclusion criteria were strictly applied. Preoperative and postoperative clinical examinations of malocclusion, maximum incisor opening (MIO), laterotrusion, and temporomandibular disorder symptoms were recorded and analyzed. Computed tomography (CT) and magnetic resonance imaging (MRI) were used to assess articular position and condylar morphology and position. Thirty-four patients with ICFs (47 sides) were treated with the modified ORIF technique. At 6 months of follow-up, no malocclusion was found and the MIO considerably expanded to 3.56 ± 0.13 cm. Only 4 patients (12%) had temporomandibular joint discomfort with mouth opening. Interestingly, for unilateral type B ICFs, the laterotrusion distance to the ORIF sides was notably longer than to the non-ORIF sides. Postoperative CT and MRI showed that all fragments were properly reduced and the condyles were in the normal position. Postoperative anterior disc displacement occurred in 4 sides and condylar morphologic abnormalities (slight surface roughening and articular cartilage absorption) occurred in 3 sides (6.4%). This modified ORIF technique, which achieved good outcomes after treatment of all ICF types, shows promise for the treatment of ICFs. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Effect of projectile on incomplete fusion reactions at low energies

    NASA Astrophysics Data System (ADS)

    Sharma, Vijay R.; Shuaib, Mohd.; Yadav, Abhishek; Singh, Pushpendra P.; Sharma, Manoj K.; Kumar, R.; Singh, Devendra P.; Singh, B. P.; Muralithar, S.; Singh, R. P.; Bhowmik, R. K.; Prasad, R.

    2017-11-01

    Present work deals with the experimental studies of incomplete fusion reaction dynamics at energies as low as ≈ 4 - 7 MeV/A. Excitation functions populated via complete fusion and/or incomplete fusion processes in 12C+175Lu, and 13C+169Tm systems have been measured within the framework of PACE4 code. Data of excitation function measurements on comparison with different projectile-target combinations suggest the existence of ICF even at slightly above barrier energies where complete fusion (CF) is supposed to be the sole contributor, and further demonstrates strong projectile structure dependence of ICF. The incomplete fusion strength functions for 12C+175Lu, and 13C+169Tm systems are analyzed as a function of various physical parameters at a constant vrel ≈ 0.053c. It has been found that one neutron (1n) excess projectile 13C (as compared to 12C) results in less incomplete fusion contribution due to its relatively large negative α-Q-value, hence, α Q-value seems to be a reliable parameter to understand the ICF dynamics at low energies. In order to explore the reaction modes on the basis of their entry state spin population, the spin distribution of residues populated via CF and/or ICF in 16O+159Tb system has been done using particle-γ coincidence technique. CF-α and ICF-α channels have been identified from backward (B) and forward (F) α-gated γspectra, respectively. Reaction dependent decay patterns have been observed in different α emitting channels. The CF channels are found to be fed over a broad spin range, however, ICF-α channels was observed only for high-spin states. Further, the existence of incomplete fusion at low bombarding energies indicates the possibility to populate high spin states

  7. An ontology-based exploration of the concepts and relationships in the activities and participation component of the international classification of functioning, disability and health.

    PubMed

    Della Mea, Vincenzo; Simoncello, Andrea

    2012-02-28

    The International Classification of Functioning, Disability and Health (ICF) is a classification of health and health-related issues, aimed at describing and measuring health and disability at both individual and population levels. Here we discuss a preliminary qualitative and quantitative analysis of the relationships used in the Activities and Participation component of ICF, and a preliminary mapping to SUMO (Suggested Upper Merged Ontology) concepts. The aim of the analysis is to identify potential logical problems within this component of ICF, and to understand whether activities and participation might be defined more formally than in the current version of ICF. In the relationship analysis, we used four predicates among those available in SUMO for processes (Patient, Instrument, Agent, and subProcess). While at the top level subsumption was used in most cases (90%), at the lower levels the percentage of other relationships rose to 41%. Chapters were heterogeneous in the relationships used and some of the leaves of the tree seemed to represent properties or parts of the parent concept rather than subclasses. Mapping of ICF to SUMO proved partially feasible, with the activity concepts being mapped mostly (but not totally) under the IntentionalProcess concept in SUMO. On the other hand, the participation concept has not been mapped to any upper level concept. Our analysis of the relationships within ICF revealed issues related to confusion between classes and their properties, incorrect classifications, and overemphasis on subsumption, confirming what already observed by other researchers. However, it also suggested some properties for Activities that could be included in a more formal model: number of agents involved, the instrument used to carry out the activity, the object of the activity, complexity of the task, and an enumeration of relevant subtasks.

  8. A review on ab initio studies of static, transport, and optical properties of polystyrene under extreme conditions for inertial confinement fusion applications

    NASA Astrophysics Data System (ADS)

    Hu, S. X.; Collins, L. A.; Boehly, T. R.; Ding, Y. H.; Radha, P. B.; Goncharov, V. N.; Karasiev, V. V.; Collins, G. W.; Regan, S. P.; Campbell, E. M.

    2018-05-01

    Polystyrene (CH), commonly known as "plastic," has been one of the widely used ablator materials for capsule designs in inertial confinement fusion (ICF). Knowing its precise properties under high-energy-density conditions is crucial to understanding and designing ICF implosions through radiation-hydrodynamic simulations. For this purpose, systematic ab initio studies on the static, transport, and optical properties of CH, in a wide range of density and temperature conditions (ρ = 0.1 to 100 g/cm3 and T = 103 to 4 × 106 K), have been conducted using quantum molecular dynamics (QMD) simulations based on the density functional theory. We have built several wide-ranging, self-consistent material-properties tables for CH, such as the first-principles equation of state, the QMD-based thermal conductivity (κQMD) and ionization, and the first-principles opacity table. This paper is devoted to providing a review on (1) what results were obtained from these systematic ab initio studies; (2) how these self-consistent results were compared with both traditional plasma-physics models and available experiments; and (3) how these first-principles-based properties of polystyrene affect the predictions of ICF target performance, through both 1-D and 2-D radiation-hydrodynamic simulations. In the warm dense regime, our ab initio results, which can significantly differ from predictions of traditional plasma-physics models, compared favorably with experiments. When incorporated into hydrocodes for ICF simulations, these first-principles material properties of CH have produced significant differences over traditional models in predicting 1-D/2-D target performance of ICF implosions on OMEGA and direct-drive-ignition designs for the National Ignition Facility. Finally, we will discuss the implications of these studies on the current small-margin ICF target designs using a CH ablator.

  9. [Global analysis of the readability of the informed consent forms used in public hospitals of Spain].

    PubMed

    Mariscal-Crespo, M I; Coronado-Vázquez, M V; Ramirez-Durán, M V

    To analyse the readability of informed consent forms (ICF) used in Public Hospitals throughout Spain, with the aim of checking their function of providing comprehensive information to people who are making any health decision no matter where they are in Spain. A descriptive study was performed on a total of 11,339 ICF received from all over Spanish territory, of which 1617 ICF were collected from 4 web pages of Health Portal and the rest (9722) were received through email and/or telephone contact from March 2012 to February 2013. The readability level was studied using the Inflesz tool. A total of 372 ICF were selected and analysed using simple random sampling. The Inflesz scale and the Flesch-Szigriszt index were used to analyse the readability. The readability results showed that 62.4% of the ICF were rated as a "little difficult", the 23.4% as "normal", and the 13.4% were rated as "very difficult". The highest readability means using the Flesch index were scored in Andalusia with a mean of 56.99 (95% CI; 55.42-58.57) and Valencia with a mean of 51.93 (95% CI; 48.4-55.52). The lowest readability means were in Galicia with a mean of 40.77 (95% CI; 9.83-71.71) and Melilla, mean=41.82 (95% CI; 35.5-48.14). The readability level of Spanish informed consent forms must be improved because their scores using readability tools could not be classified in normal scales. Furthermore, there was very wide variability among Spanish ICF, which showed a lack of equity in information access among Spanish citizens. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Linking Frailty Instruments to the International Classification of Functioning, Disability, and Health: A Systematic Review.

    PubMed

    Azzopardi, Roberta Vella; Vermeiren, Sofie; Gorus, Ellen; Habbig, Ann-Katrin; Petrovic, Mirko; Van Den Noortgate, Nele; De Vriendt, Patricia; Bautmans, Ivan; Beyer, Ingo

    2016-11-01

    To date, the major dilemma concerning frailty is the lack of a standardized language regarding its operationalization. Considering the demographic challenge that the world is facing, standardization of frailty identification is indeed the first step in tackling the burdensome consequences of frailty. To demonstrate this diversity in frailty assessment, the available frailty instruments have been linked to the International Classification of Functioning, Disability, and Health (ICF): a standardized and hierarchically coded language developed by World Health Organization regarding health conditions and their positive (functioning) and negative (disability) consequences. A systematic review on frailty instruments was carried out in PubMed, Web of Knowledge, and PsycINFO. The items of the identified frailty instruments were then linked to the ICF codes. 79 original or adapted frailty instruments were identified and categorized into single (n = 25) and multidomain (n = 54) groups. Only 5 frailty instruments (indexes) were linked to all 5 ICF components. Whereas the ICF components Body Functions and Activities and Participation were frequently linked to the frailty instruments, Body Structures, Environmental and Personal factors were sparingly represented mainly in the multidomain frailty instruments. This review highlights the heterogeneity in frailty operationalization. Environmental and personal factors should be given more thought in future frailty assessments. Being unambiguous, structured, and neutral, the ICF language allows comparing observations made with different frailty instruments. In conclusion, this systematic overview and ICF translation can be a cornerstone for future standardization of frailty assessment. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  11. Phylogeny of Maleae (Rosaceae) Based on Multiple Chloroplast Regions: Implications to Genera Circumscription

    PubMed Central

    Li, Jinlu; Yu, Jing; Wang, Ling; Yang, Xueying

    2018-01-01

    Maleae consists of economically and ecologically important plants. However, there are considerable disputes on generic circumscription due to the lack of a reliable phylogeny at generic level. In this study, molecular phylogeny of 35 generally accepted genera in Maleae is established using 15 chloroplast regions. Gillenia is the most basal clade of Maleae, followed by Kageneckia + Lindleya, Vauquelinia, and a typical radiation clade, the core Maleae, suggesting that the proposal of four subtribes is reasonable. In the core Maleae including 31 genera, chloroplast gene data support that the four Malus-related genera should better be merged into one genus and the six Sorbus-related genera would be classified into two genera, whereas all Photinia-related genera should be accepted as distinct genera. Although the phylogenetic relationships among the genera in Maleae are much clearer than before, it is still premature to make a formal taxonomic treatment for these genera. PMID:29750171

  12. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology

    NASA Astrophysics Data System (ADS)

    Gutenbrunner, Christoph; Bender, Tamas; Cantista, Pedro; Karagülle, Zeki

    2010-09-01

    Health Resort Medicine, Balneology, Medical Hydrology and Climatology are not fully recognised as independent medical specialties at a global international level. Analysing the reasons, we can identify both external (from outside the field) and internal (from inside the field) factors. External arguments include, e.g. the lack of scientific evidence, the fact that Balneotherapy and Climatotherapy is not used in all countries, and the fact that Health Resort Medicine, Balneology, Medical Hydrology and Climatology focus only on single methods and do not have a comprehensive concept. Implicit barriers are the lack of international accepted terms in the field, the restriction of being allowed to practice the activities only in specific settings, and the trend to use Balneotherapy mainly for wellness concepts. Especially the implicit barriers should be subject to intense discussions among scientists and specialists. This paper suggests one option to tackle the problem of implicit barriers by making a proposal for a structure and description of the medical field, and to provide some commonly acceptable descriptions of content and terminology. The medical area can be defined as “medicine in health resorts” (or “health resort medicine”). Health resort medicine includes “all medical activities originated and derived in health resorts based on scientific evidence aiming at health promotion, prevention, therapy and rehabilitation”. Core elements of health resort interventions in health resorts are balneotherapy, hydrotherapy, and climatotherapy. Health resort medicine can be used for health promotion, prevention, treatment, and rehabilitation. The use of natural mineral waters, gases and peloids in many countries is called balneotherapy, but other (equivalent) terms exist. Substances used for balneotherapy are medical mineral waters, medical peloids, and natural gases (bathing, drinking, inhalation, etc.). The use of plain water (tap water) for therapy is called hydrotherapy, and the use of climatic factors for therapy is called climatotherapy. Reflecting the effects of health resort medicine, it is important to take other environmental factors into account. These can be classified within the framework of the ICF (International Classification of Functioning, Disability and Health). Examples include receiving health care by specialised doctors, being well educated (ICF-domain: e355), having an environment supporting social contacts (family, peer groups) (cf. ICF-domains: d740, d760), facilities for recreation, cultural activities, leisure and sports (cf. ICF-domain: d920), access to a health-promoting atmosphere and an environment close to nature (cf. ICF-domain: e210). The scientific field dealing with health resort medicine is called health resort sciences. It includes the medical sciences, psychology, social sciences, technical sciences, chemistry, physics, geography, jurisprudence, etc. Finally, this paper proposes a systematic international discussion of descriptions in the field of Health Resort Medicine, Balneology, Medical Hydrology and Climatology, and discusses short descriptive terms with the goal of achieving internationally accepted distinct terms. This task should be done via a structured consensus process and is of major importance for the publication of scientific results as well as for systematic reviews and meta-analyses.

  13. Design of compound libraries for fragment screening

    NASA Astrophysics Data System (ADS)

    Blomberg, Niklas; Cosgrove, David A.; Kenny, Peter W.; Kolmodin, Karin

    2009-08-01

    Approaches to the design of libraries for fragment screening are illustrated with reference to a 20 k generic fragment screening library and a 1.2 k generic NMR screening library. Tools and methods for library design that have been developed within AstraZeneca are described, including Foyfi fingerprints and the Flush program for neighborhood characterization. It will be shown how Flush and the BigPicker, which selects maximally diverse sets of compounds, are used to apply the Core and Layer method for library design. Approaches to partitioning libraries into cocktails are also described.

  14. Investigation of complete and incomplete fusion in the 7Li+124Sn reaction near Coulomb barrier energies

    NASA Astrophysics Data System (ADS)

    Parkar, V. V.; Sharma, Sushil K.; Palit, R.; Upadhyaya, S.; Shrivastava, A.; Pandit, S. K.; Mahata, K.; Jha, V.; Santra, S.; Ramachandran, K.; Nag, T. N.; Rath, P. K.; Kanagalekar, Bhushan; Trivedi, T.

    2018-01-01

    The complete and incomplete fusion cross sections for the 7Li+124Sn reaction were measured using online and offline characteristic γ -ray detection techniques. The complete fusion (CF) cross sections at energies above the Coulomb barrier were found to be suppressed by ˜26 % compared to the coupled channel calculations. This suppression observed in complete fusion cross sections is found to be commensurate with the measured total incomplete fusion (ICF) cross sections. There is a distinct feature observed in the ICF cross sections, i.e., t capture is found to be dominant compared to α capture at all the measured energies. A simultaneous explanation of complete, incomplete, and total fusion (TF) data was also obtained from the calculations based on the continuum discretized coupled channel method with short range imaginary potentials. The cross section ratios of CF/TF and ICF/TF obtained from the data as well as the calculations showed the dominance of ICF at below-barrier energies and CF at above-barrier energies.

  15. Utility of the International Classification of Functioning, Disability and Health (ICF) for educational psychologists’ work

    PubMed Central

    Aljunied, Mariam; Frederickson, Norah

    2014-01-01

    Despite embracing a bio-psycho-social perspective, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists’ work with children who have Autism Spectrum Disorders (ASD). Mothers of 40 children with ASD aged eight to 12 years were interviewed using a structured protocol based on the ICF framework. The Diagnostic Interview for Social and Communication Disorder (DISCO) was completed with a subset of 19 mothers. Internal consistency and inter-rater reliability of the interview assessments were found to be acceptable and there was evidence for concurrent and discriminant validity. Despite some limitations, initial support for the utility of the ICF model suggests its potential value across educational, health and care fields. Further consideration of its relevance to educational psychologists in new areas of multi-agency working is warranted. PMID:26157197

  16. Participation and environmental aspects in education and the ICF and the ICF-CY: findings from a systematic literature review.

    PubMed

    Maxwell, Gregor; Alves, Ines; Granlund, Mats

    2012-01-01

    This paper presents findings from a systematic review of the literature related to participation and the ICF/ICF-CY in educational research. To analyse how and investigate the application of participation in educational research. Specifically, how participation is related to the environmental dimensions availability, accessibility, affordability, accommodability and acceptability. A systematic literature review using database keyword searches and refinement protocols using inclusion and exclusion criteria at abstract, full-text and extraction. Four hundred and twenty-one initial works were found. Twenty-three met the inclusion criteria. Availability and accommodations are the most investigated dimensions. Operationalization of participation is not always consistent with definitions used. Research is developing a holistic approach to investigating participation as, although all papers reference at least one environmental dimension, only four of the 11 empirical works reviewed present a fully balanced approach when theorizing and operationalizing participation; hopefully this balanced approach will continue and influence educational policy and school practice.

  17. The International Classification of Functioning, Disability and Health (ICF) and nursing.

    PubMed

    Kearney, Penelope M; Pryor, Julie

    2004-04-01

    Nursing conceptualizes disability from largely medical and individual perspectives that do not consider its social dimensions. Disabled people are critical of this paradigm and its impact on their health care. The aims of this paper are to review the International Classification of Functioning, Disability and Health (ICF), including its history and the theoretical models upon which it is based and to discuss its relevance as a conceptual framework for nursing. The paper presents a critical overview of concepts of disability and their implications for nursing and argues that a broader view is necessary. It examines ICF and its relationship to changing paradigms of disability and presents some applications for nursing. The ICF, with its acknowledgement of the interaction between people and their environments in health and disability, is a useful conceptual framework for nursing education, practice and research. It has the potential to expand nurses' thinking and practice by increasing awareness of the social, political and cultural dimensions of disability.

  18. Measuring the shock impedance mismatch between high-density carbon and deuterium at the National Ignition Facility

    DOE PAGES

    Millot, M.; Celliers, P. M.; Sterne, P. A.; ...

    2018-04-18

    Fine-grained diamond, or high-density carbon (HDC), is being used as an ablator for inertial confinement fusion (ICF) research at the National Ignition Facility (NIF). Accurate equation of state (EOS) knowledge over a wide range of phase space is critical in the design and analysis of integrated ICF experiments. Here in this paper, we report shock and release measurements of the shock impedance mismatch between HDC and liquid deuterium conducted during shock-timing experiments having a first shock in the ablator ranging between 8 and 14 Mbar. Using ultrafast Doppler imaging velocimetry to track the leading shock front, we characterize the shockmore » velocity discontinuity upon the arrival of the shock at the HDC/liquid deuterium interface. Comparing the experimental data with tabular EOS models used to simulate integrated ICF experiments indicates the need for an improved multiphase EOS model for HDC in order to achieve a significant increase in neutron yield in indirect-driven ICF implosions with HDC ablators.« less

  19. Application of the ICF in fluency disorders.

    PubMed

    Yaruss, J Scott

    2007-11-01

    Stuttering is a complicated communication disorder that can affect many aspects of a speaker's life. In addition to exhibiting observable disruptions in speech (e.g., part-word repetitions, prolongations, blocks), many people who stutter also experience broader consequences in their lives because of their stuttering. Examples include difficulty with social communication (e.g., speaking with other people, making introductions) and job-related tasks (e.g., talking on the phone, participating in meetings). Because it incorporates these types of daily experiences, the World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides an ideal framework for considering the overall experience of the stuttering disorder. The purpose of this article is to highlight the ways in which the ICF can help clinicians, people who stutter, and the general public understand the multifaceted nature of stuttering. The article will also describe how clinicians can use the ICF as a framework for developing comprehensive evaluations and providing individualized treatment plans for people who stutter.

  20. Measuring the shock impedance mismatch between high-density carbon and deuterium at the National Ignition Facility

    NASA Astrophysics Data System (ADS)

    Millot, M.; Celliers, P. M.; Sterne, P. A.; Benedict, L. X.; Correa, A. A.; Hamel, S.; Ali, S. J.; Baker, K. L.; Berzak Hopkins, L. F.; Biener, J.; Collins, G. W.; Coppari, F.; Divol, L.; Fernandez-Panella, A.; Fratanduono, D. E.; Haan, S. W.; Le Pape, S.; Meezan, N. B.; Moore, A. S.; Moody, J. D.; Ralph, J. E.; Ross, J. S.; Rygg, J. R.; Thomas, C.; Turnbull, D. P.; Wild, C.; Eggert, J. H.

    2018-04-01

    Fine-grained diamond, or high-density carbon (HDC), is being used as an ablator for inertial confinement fusion (ICF) research at the National Ignition Facility (NIF). Accurate equation of state (EOS) knowledge over a wide range of phase space is critical in the design and analysis of integrated ICF experiments. Here, we report shock and release measurements of the shock impedance mismatch between HDC and liquid deuterium conducted during shock-timing experiments having a first shock in the ablator ranging between 8 and 14 Mbar. Using ultrafast Doppler imaging velocimetry to track the leading shock front, we characterize the shock velocity discontinuity upon the arrival of the shock at the HDC/liquid deuterium interface. Comparing the experimental data with tabular EOS models used to simulate integrated ICF experiments indicates the need for an improved multiphase EOS model for HDC in order to achieve a significant increase in neutron yield in indirect-driven ICF implosions with HDC ablators.

  1. Measuring the shock impedance mismatch between high-density carbon and deuterium at the National Ignition Facility

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Millot, M.; Celliers, P. M.; Sterne, P. A.

    Fine-grained diamond, or high-density carbon (HDC), is being used as an ablator for inertial confinement fusion (ICF) research at the National Ignition Facility (NIF). Accurate equation of state (EOS) knowledge over a wide range of phase space is critical in the design and analysis of integrated ICF experiments. Here in this paper, we report shock and release measurements of the shock impedance mismatch between HDC and liquid deuterium conducted during shock-timing experiments having a first shock in the ablator ranging between 8 and 14 Mbar. Using ultrafast Doppler imaging velocimetry to track the leading shock front, we characterize the shockmore » velocity discontinuity upon the arrival of the shock at the HDC/liquid deuterium interface. Comparing the experimental data with tabular EOS models used to simulate integrated ICF experiments indicates the need for an improved multiphase EOS model for HDC in order to achieve a significant increase in neutron yield in indirect-driven ICF implosions with HDC ablators.« less

  2. Health problems and disability in long-term sickness absence: ICF coding of medical certificates.

    PubMed

    Morgell, Roland; Backlund, Lars G; Arrelöv, Britt; Strender, Lars-Erik; Nilsson, Gunnar H

    2011-11-11

    The purpose of this study was to test the feasibility of International Classification of Functioning, Disability and Health (ICF) and to explore the distribution, including gender differences, of health problems and disabilities as reflected in long-term sickness absence certificates. A total of 433 patients with long sick-listing periods, 267 women and 166 men, were included in the study. All certificates exceeding 28 days of sick-listing sent to the local office of the Swedish Social Insurance Administration of a municipality in the Stockholm area were collected during four weeks in 2004-2005. ICD-10 medical diagnosis codes in the certificates were retrieved and free text information on disabilities in body function, body structure or activity and participation were coded according to ICF short version. In 89.8% of the certificates there were descriptions of disabilities that readily could be classified according to ICF. In a reliability test 123/131 (94%) items of randomly chosen free text information were identically classified by two of the authors. On average 2.4 disability categories (range 0-9) were found per patient; the most frequent were 'Sensation of pain' (35.1% of the patients), 'Emotional functions' (34.1%), 'Energy and drive functions' (22.4%), and 'Sleep functions' (16.9%). The dominating ICD-10 diagnostic groups were 'Mental and behavioural disorders' (34.4%) and 'Diseases of the musculoskeletal system and connective tissue' (32.8%). 'Reaction to severe stress and adjustment disorders' (14.7%), and 'Depressive episode' (11.5%) were the most frequent diagnostic codes. Disabilities in mental functions and activity/participation were more commonly described among women, while disabilities related to the musculoskeletal system were more frequent among men. Both ICD-10 diagnoses and ICF categories were dominated by mental and musculoskeletal health problems, but there seems to be gender differences, and ICF classification as a complement to ICD-10 could provide a better understanding of the consequences of diseases and how individual patients can cope with their health problems. ICF is feasible for secondary classifying of free text descriptions of disabilities stated in sick-leave certificates and seems to be useful as a complement to ICD-10 for sick-listing management and research.

  3. Modulation of the cortical silent period elicited by single- and paired-pulse transcranial magnetic stimulation

    PubMed Central

    2013-01-01

    Background The cortical silent period (CSP) elicited by transcranial magnetic stimulation (TMS) is affected by changes in TMS intensity. Some studies have shown that CSP is shortened or prolonged by short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF), Those studies, however, used different TMS intensities to adjust the amplitude of the motor evoked potential (MEP). Therefore, it is unclear whether changes in CSP duration are induced by changes in TMS intensities or by SICI and ICF. The purpose of this study was to confirm the effects of muscle contractions and stimulus intensities on MEP amplitude and the duration of CSP induced by single-pulse TMS and to clarify the effects of SICI and ICF on CSP duration. MEP evoked by TMS was detected from the right first dorsal interosseous muscle in 15 healthy subjects. First, MEP and CSP were induced by single-pulse TMS with an intensity of 100% active motor threshold (AMT) at four muscle contraction levels [10%, 30%, 50%, and 70% electromyogram (EMG)]. Next, MEP and CSP were induced by seven TMS intensities (100%, 110%, 120%, 130%, 140%, 150%, and 160% AMT) during muscle contraction of 10% EMG. Finally, SICI and ICF were recorded at the four muscle contraction levels (0%, 10%, 30%, and 50% EMG). Results MEP amplitudes increased with increases in muscle contraction and stimulus intensity. However, CSP duration did not differ at different muscle contraction levels and was prolonged with increases in stimulus intensity. CSP was shortened with SICI compared with CSP induced by single-pulse TMS and with ICF at all muscle contraction levels, whereas CSP duration was not significantly changed with ICF. Conclusions We confirmed that CSP duration is affected by TMS intensity but not by the muscle contraction level. This study demonstrated that CSP is shortened with SICI, but it is not altered with ICF. These results indicate that after SICI, CSP duration is affected by the activity of inhibitory intermediate neurons that are activated by the conditioning SICI stimulus. PMID:23547559

  4. Factorial invariance of child self-report across age subgroups: a confirmatory factor analysis of ages 5 to 16 years utilizing the PedsQL 4.0 Generic Core Scales.

    PubMed

    Limbers, Christine A; Newman, Daniel A; Varni, James W

    2008-01-01

    The utilization of health-related quality of life (HRQOL) measurement in an effort to improve pediatric health and well-being and determine the value of health care services has grown dramatically over the past decade. The paradigm shift toward patient-reported outcomes (PROs) in clinical trials has provided the opportunity to emphasize the value and essential need for pediatric patient self-report. In order for HRQOL/PRO comparisons to be meaningful for subgroup analyses, it is essential to demonstrate factorial invariance. This study examined age subgroup factorial invariance of child self-report for ages 5 to 16 years on more than 8,500 children utilizing the PedsQL 4.0 Generic Core Scales. Multigroup Confirmatory Factor Analysis (MGCFA) was performed specifying a five-factor model. Two multigroup structural equation models, one with constrained parameters and the other with unconstrained parameters, were proposed to compare the factor loadings across the age subgroups. Metric invariance (i.e., equal factor loadings) across the age subgroups was demonstrated based on stability of the Comparative Fit Index between the two models, and several additional indices of practical fit including the Root Mean Squared Error of Approximation, the Non-Normed Fit Index, and the Parsimony Normed Fit Index. The findings support an equivalent five-factor structure across the age subgroups. Based on these data, it can be concluded that children across the age subgroups in this study interpreted items on the PedsQL 4.0 Generic Core Scales in a similar manner regardless of their age.

  5. The PedsQL 4.0 as a school population health measure: feasibility, reliability, and validity.

    PubMed

    Varni, James W; Burwinkle, Tasha M; Seid, Michael

    2006-03-01

    The application of health-related quality of life (HRQOL) as a school population health measure may facilitate risk assessment and resource allocation, the tracking of student health at the school and district level, the identification of health disparities among schoolchildren, and the determination of health outcomes from interventions and policy decisions at the school, district, and county level. To determine the feasibility, reliability, and validity of the 23-item PedsQL 4.0 (Pediatric Quality of Life Inventory) Generic Core Scales as a school population health measure for children and adolescents. Survey conducted in 304 classes at 18 elementary schools, 4 middle schools, and 3 high schools within a large metropolitan school district. The PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 2437 children ages 8-18 and 4227 parents of children ages 5-18. The PedsQL 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (alpha = 0.89 child, 0.92, parent report), and distinguished between healthy children and children with chronic health conditions. The PedsQL 4.0 was related to indicators of socioeconomic status (SES) at the school and district level. The PedsQL School Functioning Scale was significantly correlated with standardized achievement scores based on the Stanford 9. The results demonstrate the feasibility, reliability and validity of the PedsQL 4.0 Generic Core Scales as a school population health measure. The implications of measuring HRQOL in schoolchildren at the school, district, and county level for identifying and ameliorating health disparities are discussed.

  6. Medicaid-financed residential care for persons with mental retardation.

    PubMed

    Lakin, K C; Hall, M J

    1990-12-01

    Two sources of Medicaid support for persons with mental retardation and related conditions (MR/RC) are examined, the intermediate care facility for the mentally retarded (ICF/MR) program and the home and community-based services (HCBS) waiver. Results indicate that Medicaid support through the ICF/MR program has shown little recent growth in terms of number of persons served, although expenditures continue to increase. Medicaid's HCBS waiver is being used increasingly by States to support residential placement because of its greater flexibility and more individualized approach relative to ICF/MR care. Use of Medicaid to finance care for persons with MR/RC varies considerably across States.

  7. Medicaid-financed residential care for persons with mental retardation

    PubMed Central

    Lakin, K. Charlie; Hall, Margaret Jean

    1990-01-01

    Two sources of Medicaid support for persons with mental retardation and related conditions (MRIRC) are examined, the intermediate care facility for the mentally retarded (ICF/MR) program and the home and community-based services (HCBS) waiver. Results indicate that Medicaid support through the ICF/MR program has shown little recent growth in terms of number of persons served, although expenditures continue to increase. Medicaid's HCBS waiver is being used increasingly by States to support residential placement because of its greater flexibility and more individualized approach relative to ICF/MR care. Use of Medicaid to finance care for persons with MR/RC varies considerably across States. PMID:10113489

  8. Application of reliability-centered maintenance to boiling water reactor emergency core cooling systems fault-tree analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Choi, Y.A.; Feltus, M.A.

    1995-07-01

    Reliability-centered maintenance (RCM) methods are applied to boiling water reactor plant-specific emergency core cooling system probabilistic risk assessment (PRA) fault trees. The RCM is a technique that is system function-based, for improving a preventive maintenance (PM) program, which is applied on a component basis. Many PM programs are based on time-directed maintenance tasks, while RCM methods focus on component condition-directed maintenance tasks. Stroke time test data for motor-operated valves (MOVs) are used to address three aspects concerning RCM: (a) to determine if MOV stroke time testing was useful as a condition-directed PM task; (b) to determine and compare the plant-specificmore » MOV failure data from a broad RCM philosophy time period compared with a PM period and, also, compared with generic industry MOV failure data; and (c) to determine the effects and impact of the plant-specific MOV failure data on core damage frequency (CDF) and system unavailabilities for these emergency systems. The MOV stroke time test data from four emergency core cooling systems [i.e., high-pressure coolant injection (HPCI), reactor core isolation cooling (RCIC), low-pressure core spray (LPCS), and residual heat removal/low-pressure coolant injection (RHR/LPCI)] were gathered from Philadelphia Electric Company`s Peach Bottom Atomic Power Station Units 2 and 3 between 1980 and 1992. The analyses showed that MOV stroke time testing was not a predictor for eminent failure and should be considered as a go/no-go test. The failure data from the broad RCM philosophy showed an improvement compared with the PM-period failure rates in the emergency core cooling system MOVs. Also, the plant-specific MOV failure rates for both maintenance philosophies were shown to be lower than the generic industry estimates.« less

  9. Accommodation Outcomes and the ICF Framework

    ERIC Educational Resources Information Center

    Schreuer, Naomi

    2009-01-01

    Accommodation of the environment and technology is one of the key mediators of adjustment to disability and participation in community. In this article, accommodations are tested empirically as facilitators of return to work and participation, as defined by the "International Classification of Disability, Function, and Health" (ICF) and…

  10. The Generic Resolution Advisor and Conflict Evaluator (GRACE) for Unmanned Aircraft Detect-And-Avoid Systems

    NASA Technical Reports Server (NTRS)

    Abramson, Michael; Refai, Mohamad; Santiago, Confesor

    2017-01-01

    The paper describes the Generic Resolution Advisor and Conflict Evaluator (GRACE), a novel alerting and guidance algorithm that combines flexibility, robustness, and computational efficiency. GRACE is generic since it was designed without any assumptions regarding temporal or spatial scales, aircraft performance, or its sensor and communication systems. Therefore, GRACE was adopted as a core component of the Java Architecture for Detect-And-Avoid (DAA) Extensibility and Modeling, developed by NASA as a research and modeling tool for Unmanned Aerial Systems Integration in the National Airspace System (NAS). GRACE has been used in a number of real-time and fast-time experiments supporting evolving requirements of DAA research, including parametric studies, NAS-wide simulations, human-in-the-loop experiments, and live flight tests.

  11. A Generic Ground Framework for Image Expertise Centres and Small-Sized Production Centres

    NASA Astrophysics Data System (ADS)

    Sellé, A.

    2009-05-01

    Initiated by the Pleiadas Earth Observation Program, the CNES (French Space Agency) has developed a generic collaborative framework for its image quality centre, highly customisable for any upcoming expertise centre. This collaborative framework has been design to be used by a group of experts or scientists that want to share data and processings and manage interfaces with external entities. Its flexible and scalable architecture complies with the core requirements: defining a user data model with no impact on the software (generic access data), integrating user processings with a GUI builder and built-in APIs, and offering a scalable architecture to fit any preformance requirement and accompany growing projects. The CNES jas given licensing grants for two software companies that will be able to redistribute this framework to any customer.

  12. An overview on incomplete fusion reaction dynamics at energy range ∼ 3-8 MeV/A

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ali, Rahbar, E-mail: rahbarali1@rediffmail.com; Singh, D.; Ansari, M. Afzal

    2014-08-14

    The information of ICF reaction has been obtained from the measurement of excitation function (EF) of ERs populated in the interaction of {sup 20}Ne and {sup 16}O on {sup 55}Mn, {sup 159}Tb and {sup 156}Gd targets. Sizable enhancement in the measured cross-sections has been observed in α-emitting channels over theoretical predictions, which has been attributed to ICF of the projectile. In order to confirm the findings of the measurements and analysis of EFs, the forward recoil range distributions of ERs populated in {sup 20}Ne+{sup 159}Tb (E ∼165MeV) and {sup 16}O+{sup 156}Gd (E ∼ 72, 82 and 93MeV) systems, have beenmore » measured. It has been observed that peaks appearing at different cumulative thicknesses in the stopping medium are related with different degree of linear momentum transfer from projectile to target nucleus by adopting the break-up fusion model consideration. In order to deduce the angular momentum involved in various CF and / or ICF reaction products, spin distribution and side-feeding intensity profiles of radio-nuclides populated via CF and ICF channels in {sup 16}O+{sup 160}Gd system at energy, E ∼ 5.6 MeV/A, have been studied. Spin distribution of ICF products are found to be distinctly different than that observed from CF products.« less

  13. Disability and Profiles of Functioning of Patients with Parkinson's Disease Described with ICF Classification

    ERIC Educational Resources Information Center

    Raggi, Alberto; Leonardi, Matilde; Ajovalasit, Daniela; Carella, Francesco; Soliveri, Paola; Albanese, Alberto; Romito, Luigi

    2011-01-01

    The objective of this study was to describe the functional profiles of patients with Parkinson's disease (PD), and the relationships between impairment in body functions, limitations in activities, and environmental factors, using the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). Patients…

  14. Symposium: Compliance and Quality in Residential Life. Foreword.

    ERIC Educational Resources Information Center

    Kennedy, Edward M.

    1992-01-01

    The senator from Massachusetts introduces this special issue by reviewing his family's interest in persons with mental retardation, the potential of the Americans with Disabilities Act, the Intermediate Care Facilities for the Mentally Retarded (ICF/MR) program, and the importance of improving care for residents of ICFs. (DB)

  15. An antiproton driver for ICF propulsion

    NASA Technical Reports Server (NTRS)

    Chiang, Pi-Ren; Lewis, R. A.; Smith, G. A.; Gazze, C.; Higman, K.; Newton, R.; Chiaverini, M.; Dailey, J.; Surratt, M.; Werthman, W. Lance

    1993-01-01

    Inertial confinement fusion (ICF) utilizing an anitprotoncatalyzed target is discussed as a possible source of propulsion for rapid interplanetary manned space missions. The relevant compression, ignition, and thrust mechanisms are presented. Progress on an experiment presently in progress at the Phillips Laboratory, Kirtland AFB, NM to demonstrate proof-of-principle is reviewed.

  16. The Generic Resolution Advisor and Conflict Evaluator (GRACE) for Detect-And-Avoid Systems

    NASA Technical Reports Server (NTRS)

    Abramson, Michael; Refai, Mohamad; Santiago, Confesor

    2017-01-01

    Java Architecture for Detect-And-Avoid (DAA) Extensibility and Modeling (JADEM) was developed at NASA Ames Research Center as a research and modeling tool for Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS). UAS will be required to have DAA systems in order to fulfill the regulatory requirement to remain well clear'' of other traffic. JADEM supports research on technological requirements and Minimum Operational Performance Standards (MOPS) for UAS DAA systems by providing a flexible and extensible software platform that includes models and algorithms for all major DAA functions. This paper describes one of these algorithms, the Generic Resolution Advisor and Conflict Evaluator (GRACE). GRACE supports two core DAA functions: threat evaluation and guidance. GRACE is generic in the sense that it is designed to work with any aircraft or sensor type (both cooperative and non-cooperative), and to be used in various applications and DAA guidance concepts, thus supporting evolving MOPS requirements and research. GRACE combines flexibility, robustness, and computational efficiency. It has modest memory requirements and can handle multiple cooperative and noncooperative intruders. GRACE has been used as a core JADEM component in several real-time and fast-time experiments, including human-in-the-loop simulations and live flight tests.

  17. Yield degradation in inertial-confinement-fusion implosions due to shock-driven kinetic fuel-species stratification and viscous heating

    NASA Astrophysics Data System (ADS)

    Taitano, W. T.; Simakov, A. N.; Chacón, L.; Keenan, B.

    2018-05-01

    Anomalous thermonuclear yield degradation (i.e., that not describable by single-fluid radiation hydrodynamics) in Inertial Confinement Fusion (ICF) implosions is ubiquitously observed in both Omega and National Ignition experiments. Multiple experimental and theoretical studies have been carried out to investigate the origin of such a degradation. Relative concentration changes of fuel-ion species, as well as kinetically enhanced viscous heating, have been among possible explanations proposed for certain classes of ICF experiments. In this study, we investigate the role of such kinetic plasma effects in detail. To this end, we use the iFP code to perform multi-species ion Vlasov-Fokker-Planck simulations of ICF capsule implosions with the fuel comprising various hydrodynamically equivalent mixtures of deuterium (D) and helium-3 (3He), as in the original Rygg experiments [J. R. Rygg et al., Phys. Plasmas 13, 052702 (2006)]. We employ the same computational setup as in O. Larroche [Phys. Plasmas 19, 122706 (2012)], which was the first to simulate the experiments kinetically. However, unlike the Larroche study, and in partial agreement with experimental data, we find a systematic yield degradation in multi-species simulations versus averaged-ion simulations when the D-fuel fraction is decreased. This yield degradation originates in the fuel-ion species stratification induced by plasma shocks, which imprints the imploding system and results in the relocation of the D ions from the core of the capsule to its periphery, thereby reducing the yield relative to a non-separable averaged-ion case. By comparing yields from the averaged-ion kinetic simulations and from the hydrodynamic scaling, we also observe yield variations associated with ion kinetic effects other than fuel-ion stratification, such as ion viscous heating, which is typically neglected in hydrodynamic implosions' simulations. Since our kinetic simulations are driven by hydrodynamic boundary conditions at the fuel-ablator interface, they cannot capture the effects of ion viscosity on the capsule compression, or effects associated with the interface, which are expected to be important. Studies of such effects are left for future work.

  18. Choosing outcome assessment tools in haemophilia care and research: a multidisciplinary perspective.

    PubMed

    Fischer, K; Poonnoose, P; Dunn, A L; Babyn, P; Manco-Johnson, M J; David, J A; van der Net, J; Feldman, B; Berger, K; Carcao, M; de Kleijn, P; Silva, M; Hilliard, P; Doria, A; Srivastava, A; Blanchette, V

    2017-01-01

    The implementation of early long-term, regular clotting factor concentrate (CFC) replacement therapy ('prophylaxis') has made it possible to offer boys with haemophilia a near normal life. Many different regimens have reported favourable results, but the optimum treatment regimens have not been established and the cost of prophylaxis is very high. Both for optimizing treatment and reimbursement issues, there is a need to provide objective evidence of both short- and long-term results and benefits of prophylactic regimens. This report presents a critical review of outcome measures for use in the assessment of musculoskeletal health in persons with haemophilia according to the International Classification of Functioning, Disability and Health (ICF). This framework considers structural and functional changes, activities and participation in a context of both personal and environmental factors. Results were generated by a combination of a critical review of available literature plus expert opinion derived from a two day consensus conference between 48 health care experts from different disciplines involved in haemophilia assessment and care. Outcome tools used in haemophilia were reviewed for reliability and validity in different patient groups and for resources required. Recommendations for choice of outcome tools were made according to the ICF domains, economic setting, and reason for use (clinical or research). The next step will be to identify a 'core' set of outcome measures for use in clinical care or studies evaluating treatment. © 2016 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

  19. Spectroscopic diagnostics of NIF ICF implosions using line ratios of Kr dopant in the ignition capsule

    NASA Astrophysics Data System (ADS)

    Dasgupta, Arati; Ouart, Nicholas; Giuiani, John; Clark, Robert; Schneider, Marilyn; Scott, Howard; Chen, Hui; Ma, Tammy

    2017-10-01

    X ray spectroscopy is used on the NIF to diagnose the plasma conditions in the ignition target in indirect drive ICF implosions. A platform is being developed at NIF where small traces of krypton are used as a dopant to the fuel gas for spectroscopic diagnostics using krypton line emissions. The fraction of krypton dopant was varied in the experiments and was selected so as not to perturb the implosion. Our goal is to use X-ray spectroscopy of dopant line ratios produced by the hot core that can provide a precise measurement of electron temperature. Simulations of the krypton spectra using a 1 in 104 atomic fraction of krypton in direct-drive exploding pusher with a range of electron temperatures and densities show discrepancies when different atomic models are used. We use our non-LTE atomic model with a detailed fine-structure level atomic structure and collisional-radiative rates to investigate the krypton spectra at the same conditions. Synthetic spectra are generated with a detailed multi-frequency radiation transport scheme from the emission regions of interest to analyze the experimental data with 0.02% Kr concentration and compare and contrast with the existing simulations at LLNL. Work supported by DOE/NNSA; Part of this work was also done under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract No. DE-AC52-07NA27344.

  20. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Prasad, M.K.; Kershaw, D.S.; Shaw, M.J.

    The authors present detailed features of the ICF3D hydrodynamics code used for inertial fusion simulations. This code is intended to be a state-of-the-art upgrade of the well-known fluid code, LASNEX. ICF3D employs discontinuous finite elements on a discrete unstructured mesh consisting of a variety of 3D polyhedra including tetrahedra, prisms, and hexahedra. The authors discussed details of how the ROE-averaged second-order convection was applied on the discrete elements, and how the C++ coding interface has helped to simplify implementing the many physics and numerics modules within the code package. The author emphasized the virtues of object-oriented design in large scalemore » projects such as ICF3D.« less

  1. Disability and Functional Profiles of Patients with Myasthenia Gravis Measured with ICF Classification

    ERIC Educational Resources Information Center

    Leonardi, Matilde; Raggi, Alberto; Antozzi, Carlo; Confalonieri, Paolo; Maggi, Lorenzo; Cornelio, Ferdinando; Mantegazza, Renato

    2009-01-01

    The objective of this study is to describe functional profiles of patients with myasthenia gravis (MG), and the relationships among symptoms, activities and environmental factors (EF), by using WHO's International Classification of Functioning Disability and Health (ICF). Patients were consecutively enrolled at the Besta Institute of Milan, Italy.…

  2. 42 CFR 447.272 - Inpatient services: Application of upper payment limits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... inpatient services furnished by hospitals, nursing facilities, and ICFs/MR within one of the following... are funded through the Indian Self-Determination and Education Assistance Act (Pub. L. 93-638). (2... hospitals, nursing facilities and ICFs/MR “ Medicaid State plan rate year 2008. (2) For all other facilities...

  3. Implications of the International Classification of Functioning, Disability and Health (ICF) for Test Development and Use

    ERIC Educational Resources Information Center

    Carlson, Janet F.; Benson, Nicholas; Oakland, Thomas

    2010-01-01

    Implications of the International Classification of Functioning, Disability and Health (ICF) on the development and use of tests in school settings are enumerated. We predict increased demand for behavioural assessments that consider a person's activities, participation and person-environment interactions, including measures that: (a) address…

  4. Goals and Characteristics of Long-Term Care Programs: An Analytic Model.

    ERIC Educational Resources Information Center

    Braun, Kathryn L.; Rose, Charles L.

    1989-01-01

    Used medico-social analytic model to compare five long-term care programs: Skilled Nursing Facility-Intermediate Care Facility (SNF-ICF) homes, ICF homes, foster homes, day hospitals, and home care. Identified similarities and differences among programs. Preliminary findings suggest that model is useful in the evaluation and design of long-term…

  5. Choice-Making among Medicaid HCBS and ICF/MR Recipients in Six States

    ERIC Educational Resources Information Center

    Lakin, K. Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger; Taub, Sarah; Chiri, Giuseppina

    2008-01-01

    Choice in everyday decisions and in support-related decisions was addressed among 2,398 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services and living in nonfamily settings in six states. Everyday choice in daily life and in…

  6. Utility of the International Classification of Functioning, Disability and Health (ICF) for Educational Psychologists' Work

    ERIC Educational Resources Information Center

    Aljunied, Mariam; Frederickson, Norah

    2014-01-01

    Despite embracing a bio-psycho-social perspective, the World Health Organization's International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists' work with…

  7. Damage mechanisms avoided or managed for NIF large optics

    DOE PAGES

    Manes, K. R.; Spaeth, M. L.; Adams, J. J.; ...

    2016-02-09

    After every other failure mode has been considered, in the end, the high-performance limit of all lasers is set by optical damage. The demands of inertial confinement fusion (ICF) pushed lasers designed as ICF drivers into this limit from their very earliest days. The first ICF lasers were small, and their pulses were short. Their goal was to provide as much power to the target as possible. Typically, they faced damage due to high intensity on their optics. As requests for higher laser energy, longer pulse lengths, and better symmetry appeared, new kinds of damage also emerged, some of themmore » anticipated and others unexpected. This paper will discuss the various types of damage to large optics that had to be considered, avoided to the extent possible, or otherwise managed as the National Ignition Facility (NIF) laser was designed, fabricated, and brought into operation. Furthermore, it has been possible for NIF to meet its requirements because of the experience gained in previous ICF systems and because NIF designers have continued to be able to avoid or manage new damage situations as they have appeared.« less

  8. Hybrid-drive implosion system for ICF targets

    DOEpatents

    Mark, James W.

    1988-08-02

    Hybrid-drive implosion systems (20,40) for ICF targets (10,22,42) are described which permit a significant increase in target gain at fixed total driver energy. The ICF target is compressed in two phases, an initial compression phase and a final peak power phase, with each phase driven by a separate, optimized driver. The targets comprise a hollow spherical ablator (12) surroundingly disposed around fusion fuel (14). The ablator is first compressed to higher density by a laser system (24), or by an ion beam system (44), that in each case is optimized for this initial phase of compression of the target. Then, following compression of the ablator, energy is directly delivered into the compressed ablator by an ion beam driver system (30,48) that is optimized for this second phase of operation of the target. The fusion fuel (14) is driven, at high gain, to conditions wherein fusion reactions occur. This phase separation allows hydrodynamic efficiency and energy deposition uniformity to be individually optimized, thereby securing significant advantages in energy gain. In additional embodiments, the same or separate drivers supply energy for ICF target implosion.

  9. Hybrid-drive implosion system for ICF targets

    DOEpatents

    Mark, James W.

    1988-01-01

    Hybrid-drive implosion systems (20,40) for ICF targets (10,22,42) are described which permit a significant increase in target gain at fixed total driver energy. The ICF target is compressed in two phases, an initial compression phase and a final peak power phase, with each phase driven by a separate, optimized driver. The targets comprise a hollow spherical ablator (12) surroundingly disposed around fusion fuel (14). The ablator is first compressed to higher density by a laser system (24), or by an ion beam system (44), that in each case is optimized for this initial phase of compression of the target. Then, following compression of the ablator, energy is directly delivered into the compressed ablator by an ion beam driver system (30,48) that is optimized for this second phase of operation of the target. The fusion fuel (14) is driven, at high gain, to conditions wherein fusion reactions occur. This phase separation allows hydrodynamic efficiency and energy deposition uniformity to be individually optimized, thereby securing significant advantages in energy gain. In additional embodiments, the same or separate drivers supply energy for ICF target implosion.

  10. Hybrid-drive implosion system for ICF targets

    DOEpatents

    Mark, J.W.K.

    1987-10-14

    Hybrid-drive implosion systems for ICF targets are described which permit a significant increase in target gain at fixed total driver energy. The ICF target is compressed in two phases, an initial compression phase and a final peak power phase, with each phase driven by a separate, optimized driver. The targets comprise a hollow spherical ablator surroundingly disposed around fusion fuel. The ablator is first compressed to higher density by a laser system, or by an ion beam system, that in each case is optimized for this initial phase of compression of the target. Then, following compression of the ablator, energy is directly delivered into the compressed ablator by an ion beam driver system that is optimized for this second phase of operation of the target. The fusion fuel is driven, at high gain, to conditions wherein fusion reactions occur. This phase separation allows hydrodynamic efficiency and energy deposition uniformity to be individually optimized, thereby securing significant advantages in energy gain. In additional embodiments, the same or separate drivers supply energy for ICF target implosion. 3 figs.

  11. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sterling, N. C.; Mashburn, A. L.; Madonna, S.

    We identify [Se iii] 1.0994 μ m in the planetary nebula (PN) NGC 5315 and [Kr vi] 1.2330 μ m in three PNe from spectra obtained with the Folded-Port InfraRed Echellette (FIRE) spectrometer on the 6.5 m Baade Telescope. Se and Kr are the two most widely detected neutron-capture elements in astrophysical nebulae, and can be enriched by s -process nucleosynthesis in PN progenitor stars. The detection of [Se iii] 1.0994 μ m is particularly valuable when paired with observations of [Se iv] 2.2864 μ m, as it can be used to improve the accuracy of nebular Se abundance determinations,more » and allows Se ionization correction factor (ICF) schemes to be empirically tested for the first time. We present new effective collision strength calculations for Se{sup 2+} and Kr{sup 5+}, which we use to compute ionic abundances. In NGC 5315, we find that the Se abundance computed from Se{sup 3+}/H{sup +} is lower than that determined with ICFs that incorporate Se{sup 2+}/H{sup +}. We compute new Kr ICFs that take Kr{sup 5+}/H{sup +} into account, by fitting correlations found in grids of Cloudy models between Kr ionic fractions and those of more abundant elements, and use these to derive Kr abundances in four PNe. Observations of [Se iii] and [Kr vi] in a larger sample of PNe, with a range of excitation levels, are needed to rigorously test the ICF prescriptions for Se and our new Kr ICFs.« less

  12. Measuring patterns of disability using the International Classification of Functioning, Disability and Health in the post-acute stroke rehabilitation setting.

    PubMed

    Goljar, Nika; Burger, Helena; Vidmar, Gaj; Leonardi, Matilde; Marincek, Crt

    2011-06-01

    To determine whether the International Classification of Functioning, Disability and Health (ICF) model is adequate for assessing disability patterns in stroke survivors in the sub-acute rehabilitation setting in terms of potential changes in functional profiles over time. Functional profiles of 197 stroke patients were assessed using the ICF Checklist and the Functional Independence Measure (FIMTM) at admission and discharge from rehabilitation hospital. The ICF Checklist was applied based on medical documentation and rehabilitation team meetings. Descriptive analyses were performed to identify changes in ICF categories and qualifiers from admission to discharge, and correlations between different improvement measures were calculated. Mean rehabilitation duration was 60 days; patients' mean age was 60 years, with mean FIM-score 75 at admission. Mean FIM-score improvement at discharge was 12.5. Within Body Functions, changes in at least 10% of patients were found regarding 13 categories; no categories within Body Structures, 24 within Activities and Participation, and 2 within Environmental Factors. Changes were mostly due to improvement in qualifiers, except for within Environmental Factors, where they were due to use of additional categories. Correlations between improvements in Body Functions and Activities and Participation (regarding capacity and performance), as well as between capacity and performance within Activities and Participation, were approximately 0.4. Rating ICF categories with qualifiers enables the detection of changes in functional profiles of stroke patients who underwent an inpatient rehabilitation programme. :

  13. Communication: An efficient approach to compute state-specific nuclear gradients for a generic state-averaged multi-configuration self consistent field wavefunction.

    PubMed

    Granovsky, Alexander A

    2015-12-21

    We present a new, very efficient semi-numerical approach for the computation of state-specific nuclear gradients of a generic state-averaged multi-configuration self consistent field wavefunction. Our approach eliminates the costly coupled-perturbed multi-configuration Hartree-Fock step as well as the associated integral transformation stage. The details of the implementation within the Firefly quantum chemistry package are discussed and several sample applications are given. The new approach is routinely applicable to geometry optimization of molecular systems with 1000+ basis functions using a standalone multi-core workstation.

  14. Communication: An efficient approach to compute state-specific nuclear gradients for a generic state-averaged multi-configuration self consistent field wavefunction

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Granovsky, Alexander A., E-mail: alex.granovsky@gmail.com

    We present a new, very efficient semi-numerical approach for the computation of state-specific nuclear gradients of a generic state-averaged multi-configuration self consistent field wavefunction. Our approach eliminates the costly coupled-perturbed multi-configuration Hartree-Fock step as well as the associated integral transformation stage. The details of the implementation within the Firefly quantum chemistry package are discussed and several sample applications are given. The new approach is routinely applicable to geometry optimization of molecular systems with 1000+ basis functions using a standalone multi-core workstation.

  15. A review on ab initio studies of static, transport, and optical properties of polystyrene under extreme conditions for inertial confinement fusion applications

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Collins, L. A.; Boehly, T. R.; Ding, Y. H.

    Polystyrene (CH), commonly known as “plastic,” has been one of the widely used ablator materials for capsule designs in inertial confinement fusion (ICF). Knowing its precise properties under high-energy-density conditions is crucial to understanding and designing ICF implosions through radiation–hydrodynamic simulations. For this purpose, systematic ab initio studies on the static, transport, and optical properties of CH, in a wide range of density and temperature conditions (ρ= 0.1 to 100 g/cm 3 and T = 10 3 to 4 × 10 6K), have been conducted using quantum molecular dynamics (QMD) simulations based on the density functional theory. We have builtmore » several wide-ranging, self-consistent material-properties tables for CH, such as the first-principles equation of state (FPEOS), the QMD-based thermal conductivity (Κ QMD) and ionization, and the first-principles opacity table (FPOT). This paper is devoted to providing a review on (1) what results were obtained from these systematic ab initio studies; (2) how these self-consistent results were compared with both traditional plasma-physics models and available experiments; and (3) how these first-principles–based properties of polystyrene affect the predictions of ICF target performance, through both 1-D and 2-D radiation–hydrodynamic simulations. In the warm dense regime, our ab initio results, which can significantly differ from predictions of traditional plasma-physics models, compared favorably with experiments. When incorporated into hydrocodes for ICF simulations, these first-principles material properties of CH have produced significant differences over traditional models in predicting 1-D/2-D target performance of ICF implosions on OMEGA and direct-drive–ignition designs for the National Ignition Facility. Lastly, we will discuss the implications of these studies on the current small-margin ICF target designs using a CH ablator.« less

  16. Assessment of neurogenic bowel dysfunction impact after spinal cord injury using the International Classification of Functioning, Disability and Health.

    PubMed

    Pires, Jennifer M; Ferreira, Ana M; Rocha, Filipa; Andrade, Luis G; Campos, Inês; Margalho, Paulo; Laíns, Jorge

    2018-05-09

    Bowel function is frequently compromised after spinal cord injury (SCI). Regardless of this crucial importance in patients' lives, there is still scarce literature on the Neurogenic Bowel Dysfunction (NBD) deleterious impact on SCI patient's lives and only few studies correlating NBD severity with quality of life (QoL). To our knowledge there are no studies assessing the impact of NBD on the context of ICF domains. To assess NBD after SCI using ICF domains and to assess its impact in QoL. Retrospective data analysis and cross-sectional phone survey. Outpatient spinal cord injury setting. Portuguese adult spinal cord injury patients. Retrospective analysis of demographic data, lesion characteristics and bowel management methods at last inpatient discharge. Cross-sectional phone survey assessing current bowel management methods, the Neurogenic Bowel Dysfunction Score and a Likert scale questionnaire about the impact on ICF domains and QoL. 64 patients answered the questionnaire. The majority was male (65.6%), mean age 56.6±15.6 years, AIS A lesion (39.1%), with a traumatic cause (71.9%). The main bowel management methods were contact laxatives, suppositories and osmotic laxatives. 50.1% of patients scored moderate or severe NBD. Considering ICF domains, the greatest impact was in personal and environmental factors, with 39.1% reporting impact in financial costs, 45.3% in need of assistance, 45.3% in emotional health and 46.9% in loss of privacy. There was a significant association between severity of NBD and negative impact on QoL (p<0.05). The study confirms the major impact of NBD on personal and environmental factors of ICF and on the quality of life of SCI population. These findings confirm that it is relevant to identify the main ICF domains affected by NBD after SCI in order to address targeted interventions, working toward changes in health policies and psychosocial aspects.

  17. A review on ab initio studies of static, transport, and optical properties of polystyrene under extreme conditions for inertial confinement fusion applications

    DOE PAGES

    Collins, L. A.; Boehly, T. R.; Ding, Y. H.; ...

    2018-03-23

    Polystyrene (CH), commonly known as “plastic,” has been one of the widely used ablator materials for capsule designs in inertial confinement fusion (ICF). Knowing its precise properties under high-energy-density conditions is crucial to understanding and designing ICF implosions through radiation–hydrodynamic simulations. For this purpose, systematic ab initio studies on the static, transport, and optical properties of CH, in a wide range of density and temperature conditions (ρ= 0.1 to 100 g/cm 3 and T = 10 3 to 4 × 10 6K), have been conducted using quantum molecular dynamics (QMD) simulations based on the density functional theory. We have builtmore » several wide-ranging, self-consistent material-properties tables for CH, such as the first-principles equation of state (FPEOS), the QMD-based thermal conductivity (Κ QMD) and ionization, and the first-principles opacity table (FPOT). This paper is devoted to providing a review on (1) what results were obtained from these systematic ab initio studies; (2) how these self-consistent results were compared with both traditional plasma-physics models and available experiments; and (3) how these first-principles–based properties of polystyrene affect the predictions of ICF target performance, through both 1-D and 2-D radiation–hydrodynamic simulations. In the warm dense regime, our ab initio results, which can significantly differ from predictions of traditional plasma-physics models, compared favorably with experiments. When incorporated into hydrocodes for ICF simulations, these first-principles material properties of CH have produced significant differences over traditional models in predicting 1-D/2-D target performance of ICF implosions on OMEGA and direct-drive–ignition designs for the National Ignition Facility. Lastly, we will discuss the implications of these studies on the current small-margin ICF target designs using a CH ablator.« less

  18. SU-E-T-477: An Efficient Dose Correction Algorithm Accounting for Tissue Heterogeneities in LDR Brachytherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mashouf, S; Lai, P; Karotki, A

    2014-06-01

    Purpose: Seed brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose surrounding the brachytherapy seeds is based on American Association of Physicist in Medicine Task Group No. 43 (TG-43 formalism) which generates the dose in homogeneous water medium. Recently, AAPM Task Group No. 186 emphasized the importance of accounting for tissue heterogeneities. This can be done using Monte Carlo (MC) methods, but it requires knowing the source structure and tissue atomic composition accurately. In this work we describe an efficient analytical dose inhomogeneity correction algorithm implemented usingmore » MIM Symphony treatment planning platform to calculate dose distributions in heterogeneous media. Methods: An Inhomogeneity Correction Factor (ICF) is introduced as the ratio of absorbed dose in tissue to that in water medium. ICF is a function of tissue properties and independent of source structure. The ICF is extracted using CT images and the absorbed dose in tissue can then be calculated by multiplying the dose as calculated by the TG-43 formalism times ICF. To evaluate the methodology, we compared our results with Monte Carlo simulations as well as experiments in phantoms with known density and atomic compositions. Results: The dose distributions obtained through applying ICF to TG-43 protocol agreed very well with those of Monte Carlo simulations as well as experiments in all phantoms. In all cases, the mean relative error was reduced by at least 50% when ICF correction factor was applied to the TG-43 protocol. Conclusion: We have developed a new analytical dose calculation method which enables personalized dose calculations in heterogeneous media. The advantages over stochastic methods are computational efficiency and the ease of integration into clinical setting as detailed source structure and tissue segmentation are not needed. University of Toronto, Natural Sciences and Engineering Research Council of Canada.« less

  19. Patient consent to publication and data sharing in industry and NIH-funded clinical trials.

    PubMed

    Spence, O'Mareen; Onwuchekwa Uba, Richie; Shin, Seongbin; Doshi, Peter

    2018-05-03

    Participants are recruited into clinical trials under the assumption that the research will contribute to medical knowledge. Therefore, non-publication trials-and, more recently, lack of data sharing-are widely considered to violate the trust of trial participants. Existing practices regarding patient consent to publication and data sharing have not been evaluated. Analyzing informed consent forms (ICFs), we studied what trial participants were told regarding investigators' intention to contribute to medical knowledge, publish trial results, and share de-identified trial data. We obtained 98 ICFs of industry-funded pre-marketing trials for all (17) antibiotics approved by the European Medicines Agency and 46 ICFs of publicly funded trials from the National Heart, Lung and Blood Institute Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) data repository. Three authors independently reviewed ICFs to identify and extract what was stated or implied regarding: (1) publication of results; (2) sharing de-identified data; (3) data ownership; (4) confidentiality of identifiable data; and (5) whether the trial will produce knowledge that offers public benefit. Consensus was obtained from the two reviewers with the greatest overall agreement on all five measures. Disagreements were resolved through discussion among all authors. Four (3%) trials indicated a commitment to publish trial results; 140 (97%) did not commit to publishing trial results; six (4%) indicated a commitment to share de-identified data with third party researchers. Commitments to share were more common in publicly funded trials than industry-funded trials (7% vs 3%). A total of 103 (72%) ICFs indicated the trials will or may produce knowledge that offers public benefits, while 131 (91%) ICFs left unstated who "owned" trial data; of those with statements, the sponsor always claimed ownership. Patient confidentiality was guaranteed in 137 (95%) trials. Our results suggest that consent forms rarely disclose investigators' intentions regarding the sharing of de-identified data or publication of trial results.

  20. New CNO Elemental Abundances in Planetary Nebulae from Spatially Resolved UV/Optical Emission Lines

    NASA Astrophysics Data System (ADS)

    Shaw, Richard A.; Kwitter, Karen B.; Henry, Richard B. C.; Dufour, Reginald J.; Balick, Bruce; Corradi, Romano

    2015-01-01

    We obtained HST/STIS long-slit spectra spanning 0.11 to 1.1 μm of co-spatial regions in 10 Galactic planetary nebulae (Dufour, et al., this conference), of which six present substantial changes in ionization with position. Under the assumption that elemental abundances are constant within these nebulae (but exterior to the wind of the central star), these spectra present a unique opportunity to examine the applicability of common ionization correction factors (ICFs) for deriving abundances. ICFs are the most common direct method in abundance analysis for accounting for unobserved or undetected ionization stages in nebulae, yet most ICF recipes have not been rigorously examined through modeling nor empirically tested through observation. In this preliminary study, we focussed on the astrophysically important abundances of C and N where strong ionic transitions are scarce in optical band, but plentiful in the satellite UV. We derived physical diagnostics (extinction, Te, Ne) and ionic abundances for the species of interest at various positions along the slit for each PN. We compared the elemental abundances derived from direct summation of the ionic abundances in the UV and optical to those derived using only optical emission, but corrected using standard ICFs. We found that the abundances were usually in good agreement, but there were significant exceptions. We also found that setting upper limits on emission from undetected ions was sometimes helpful in constraining the correction factors. Work is underway to construct photoionization models of these nebulae (see Miller, et al., this conference) to address the question of why ICFs are sometimes inaccurate, and to explore other ICF recipes for those cases.Support for Program number GO-12600 was provided by NASA through a grant from the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Incorporated, under NASA contract NAS5-26555.

  1. In-vitro examination of the positive inotropic effect of caffeine and taurine, the two most frequent active ingredients of energy drinks.

    PubMed

    Chaban, R; Kornberger, A; Branski, N; Buschmann, K; Stumpf, N; Beiras-Fernandez, A; Vahl, C F

    2017-08-10

    Our study aimed to evaluate changes in the contractile behavior of human myocardium after exposure to caffeine and taurine, the main active ingredients of energy drinks (EDs), and to evaluate whether taurine exhibits any inotropic effect at all in the dosages commonly used in EDs. Myocardial tissue was removed from the right atrial appendages of patients undergoing cardiac surgery and prepared to obtain specimens measuring 4 mm in length. A total of 92 specimens were exposed to electrical impulses at a frequency of 75 bpm for at least 40 min to elicit their maximum contractile force before measuring the isometric contractile force (ICF) and duration of contraction (CD). Following this, each specimen was treated with either taurine (group 1, n = 29), or caffeine (group 2, n = 31) or both (group 3, n = 32). After exposure, ICF and CD measuring were repeated. Post-treatment values were compared with pre-treatments values and indicated as percentages. Exposure to taurine did not alter the contraction behavior of the specimens. Exposure to caffeine, in contrast, led to a significant increase in ICF (118 ± 03%, p < 0.01) und a marginal decrease in CD (95 ± 1.6%, p < 0.01). Exposure to a combination of caffeine and taurine also induced a statistically significant increase in ICF (124 ± 4%, p < 0.01) and a subtle reduction in CD (92 ± 1.4%, p < 0.01). The increase in ICF achieved by administration of caffeine was similar to that achieved by a combination of both caffeine and taurine (p = 0.2). The relative ICF levels achieved by administration of caffeine and a combination of taurine and caffeine, respectively, were both significantly higher (p < 0.01) than the ICF resulting from exposure to taurine only. While caffeine altered the contraction behavior of the specimen significantly in our in-vitro model, taurine did not exhibit a significant effect. Adding taurine to caffeine did not significantly enhance or reduce the effect of caffeine.

  2. [Validity and reliability of Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales in Chinese children and adolescents].

    PubMed

    Chen, Yu-Ming; He, Li-Ping; Mai, Jin-Cheng; Hao, Yuan-Tao; Xiong, Li-Hua; Chen, Wei-Qing; Wu, Jiang-Nan

    2008-06-01

    To evaluate the reliability and validity of parent proxy-report scales of Pediatric Quality of Life Inventory Version 4.0 (PedsQL 4.0) Generic Core Scales, the Chinese Version. 3493 school students aged 6-18 years were recruited using multistage cluster sampling method. Health-related quality of life was assessed using the above-mentioned PedsQL 4.0 scales. The internal consistency was assessed, using Cronbach's a coefficient, while its validity was tested through correlation analysis, t-test and exploratory factor analysis. The internal consistency reliability for Total Scale Score (Cronbach's alpha = 0.90), Physical Health Summary Score (alpha= 0.81), and Psychosocial Health Summary Score (alpha= 0.89) were excellent. Six major factors were extracted by factor analysis which basically matched the designed structure of the original version accounting for nearly 66% of the variance. The total Scale Score significantly decreased by 3.5 to 13.3 (P < 0.05) in children and adolescents who had diseases including cold, skin hypersensitiveness, food allergy, courbature or arthralgia, breathlessness with a frequency of 6 times or more per year or had asthma as compared to those with lower frequency (< or = 5 times/y) of the diseases or without asthma. We found moderate to high correlations between items and the subscales. Correlation coefficients ranged between 0.45 to 0.84 (P < 0.01). The reliability and validity of the parent proxy-report scales of PedsQL 4.0 Generic Core Scales of the Chinese Version were as good as the original version. Our findings suggested that the scales could be applied to evaluate the health-related quality of life in childhood children in similar Chinese regions to Guangzhou.

  3. Health-related quality of life in young adult patients with rheumatoid arthritis in Iran: reliability and validity of the Persian translation of the PedsQL™ 4.0 Generic Core Scales Young Adult Version.

    PubMed

    Pakpour, Amir H; Zeidi, Isa Mohammadi; Hashemi, Fariba; Saffari, Mohsen; Burri, Andrea

    2013-01-01

    The objective of the present study was to determine the reliability and validity of the Persian translation of the Pediatric Quality of Life Inventory (PedsQL™) 4.0 Generic Core Scales Young Adult Version in an Iranian sample of young adult patients with rheumatoid arthritis (RA). One hundred ninety-seven young adult patients with RA completed the 23-item PedsQL™ and the 36-item Short-Form Health Survey (SF-36). Disease activity based on Disease Activity Score 28 was also measured. Internal consistency and test-retest reliability, as well as construct, discriminant, and convergent validity, were tested. Confirmatory factor analysis (CFA) was used to verify the original factor structure of the PedsQL™. Also, responsiveness to change in PedsQL™ scores over time was assessed. Cronbach's alpha coefficients ranged from α = 0.82 to α = 0.91. Test-retest reproducibility was satisfactory for all scales and the total scale score. The PedsQL proved good convergent validity with the SF-36. The PedsQL distinguished well between young adult patients and healthy young adults and also RA groups with different comorbidities. The CFA did not confirm the original four-factor model, instead, analyses revealed a best-fitting five-factor model for the PedsQL™ Young Adult Version. Repeated measures analysis of variance indicated that the PedsQL scale scores for young adults increased significantly over time. The Persian translation of the PedsQL™ 4.0 Generic Core Scales Young Adult Version demonstrated good psychometric properties in young adult patients with RA and can be recommended for the use in RA research in Iran.

  4. Psychometric properties of the Sinhala version of the PedsQL™ 4.0 Generic Core Scales in early adolescents in Sri Lanka

    PubMed Central

    2012-01-01

    Background The concept Health related Quality of life (HRQOL) is increasingly recognized as an important health outcome measure in clinical and research fields. The present study attempted to evaluate the psychometric properties of the Sinhala version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales among adolescents in Sri Lanka. Methods The original US PedsQL™ was translated into Sinhala and conceptually validated according to international guidelines. A cross-sectional study was conducted among 142 healthy school going adolescents (12-14 years), their parents (n = 120) and a group of adolescents with asthma who attended asthma clinics (n = 115). Reliability was assessed using Cronbach’s alpha and validity by examining scale structure, exploring inter-scale correlations and comparing across known groups (healthy vs. chronically ill). Results The PedsQL™ Sinhala version was found to be acceptable with minimal missing responses. All scales demonstrated satisfactory reliability. Cronbach’s alpha for the total scale scores was 0.85 for adolescent self-report while for the parent proxy-report for the healthy group it was 0.86. No floor effects were observed. Ceiling effects were noticed in self-report and parent proxy-report for the healthy group. Overall results of the multi trait scaling analysis confirmed the scale structure with 74% item-convergent validity, 88% item-discriminant validity and an overall scaling success of 72%. Moderate to high correlations were shown among the domains of teen self-report (Spearman rho = .37-.54) and between teen self-report and parent proxy-reports (Spearman rho = .41-.57). The PedsQL™ tool was able to discriminate between the quality of life in healthy adolescents and adolescents with asthma. Conclusion The findings support the reliability and validity of the Sinhala version of the PedsQL™ 4.0 Generic Core Scales as a generic instrument to measure HRQOL among early adolescents in Sri Lanka in a population setting. PMID:22947113

  5. Recommendation for measuring clinical outcome in distal radius fractures: a core set of domains for standardized reporting in clinical practice and research.

    PubMed

    Goldhahn, Jörg; Beaton, Dorcas; Ladd, Amy; Macdermid, Joy; Hoang-Kim, Amy

    2014-02-01

    Lack of standardization of outcome measurement has hampered an evidence-based approach to clinical practice and research. We adopted a process of reviewing evidence on current use of measures and appropriate theoretical frameworks for health and disability to inform a consensus process that was focused on deriving the minimal set of core domains in distal radius fracture. We agreed on the following seven core recommendations: (1) pain and function were regarded as the primary domains, (2) very brief measures were needed for routine administration in clinical practice, (3) these brief measures could be augmented by additional measures that provide more detail or address additional domains for clinical research, (4) measurement of pain should include measures of both intensity and frequency as core attributes, (5) a numeric pain scale, e.g. visual analogue scale or visual numeric scale or the pain subscale of the patient-reported wrist evaluation (PRWE) questionnaires were identified as reliable, valid and feasible measures to measure these concepts, (6) for function, either the Quick Disability of the arm, shoulder and hand questionnaire or PRWE-function subscale was identified as reliable, valid and feasible measures, and (7) a measure of participation and treatment complications should be considered core outcomes for both clinical practice and research. We used a sound methodological approach to form a comprehensive foundation of content for outcomes in the area of distal radius fractures. We recommend the use of symptom and function as separate domains in the ICF core set in clinical research or practice for patients with wrist fracture. Further research is needed to provide more definitive measurement properties of measures across all domains.

  6. The Development of an ICF-Oriented, Adaptive Physician Assessment Instrument of Mobility, Self-care, and Domestic Life

    ERIC Educational Resources Information Center

    Farin, Erik; Fleitz, Annette

    2009-01-01

    The objective of this study was development and psychometric testing of an adaptive, International Classification of Functioning, Disability, and Health (ICF)-oriented questionnaire to be processed by the rehabilitation physician that aids in assessing mobility, self-care, and domestic life (Moses-Physician). The intent is to develop a physician…

  7. Perspectives on the International Classification of Functioning, Disability, and Health: Child and Youth Version (ICF-CY) and Occupational Therapy Practice

    ERIC Educational Resources Information Center

    Cramm, Heidi; Aiken, Alice B.; Stewart, Debra

    2012-01-01

    Classifying disability for children and youth has typically meant describing a diagnosis or developmental lag. The publication of the "International Classification of Functioning, Disability and Health: Child & Youth" version (ICF-CY) marks a global paradigm shift in the conceptualization and classification of childhood disability. Knowledge and…

  8. Coleman performs a CFE ICF-2 Test

    NASA Image and Video Library

    2011-01-18

    ISS026-E-018760 (18 Jan. 2011) --- NASA astronaut Catherine (Cady) Coleman, Expedition 26 flight engineer, performs a Capillary Flow Experiment (CFE) Interior Corner Flow 2 (ICF-2) test. The CFE is positioned on a Maintenance Work Area in the Destiny laboratory of the International Space Station. CFE observes the flow of fluid, in particular capillary phenomena, in microgravity.

  9. Coleman performs a CFE ICF-2 Test

    NASA Image and Video Library

    2011-01-18

    ISS026-E-018749 (18 Jan. 2011) --- NASA astronaut Catherine (Cady) Coleman, Expedition 26 flight engineer, performs a Capillary Flow Experiment (CFE) Interior Corner Flow 2 (ICF-2) test. The CFE is positioned on a Maintenance Work Area in the Destiny laboratory of the International Space Station. CFE observes the flow of fluid, in particular capillary phenomena, in microgravity.

  10. Coleman performs a CFE ICF-2 Test

    NASA Image and Video Library

    2011-01-18

    ISS026-E-018751 (18 Jan. 2011) --- NASA astronaut Catherine (Cady) Coleman, Expedition 26 flight engineer, performs a Capillary Flow Experiment (CFE) Interior Corner Flow 2 (ICF-2) test. The CFE is positioned on a Maintenance Work Area in the Destiny laboratory of the International Space Station. CFE observes the flow of fluid, in particular capillary phenomena, in microgravity.

  11. 75 FR 8649 - Request for Comments on Methodology for Conducting an Independent Study of the Burden of Patent...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ...] Request for Comments on Methodology for Conducting an Independent Study of the Burden of Patent-Related... methodologies for performing such a study (Methodology Report). ICF has now provided the USPTO with its Methodology Report, in which ICF recommends methodologies for addressing various topics about estimating the...

  12. Current Methods of Evaluating Speech-Language Outcomes for Preschoolers with Communication Disorders: A Scoping Review Using the ICF-CY

    ERIC Educational Resources Information Center

    Cunningham, Barbara Jane; Washington, Karla N.; Binns, Amanda; Rolfe, Katelyn; Robertson, Bernadette; Rosenbaum, Peter

    2017-01-01

    Purpose: The purpose of this scoping review was to identify current measures used to evaluate speech-language outcomes for preschoolers with communication disorders within the framework of the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY; World Health Organization, 2007). Method: The review…

  13. The Importance of Motor Functional Levels from the Activity Limitation Perspective of ICF in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Mutlu, Akmer

    2010-01-01

    Our purpose in this study was to evaluate performance and capacity as defined by Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) from the "activity limitation" perspective of International Classification of Functioning, Disability, and Health (ICF) and to investigate the relationship between the…

  14. Laser or charged-particle-beam fusion reactor with direct electric generation by magnetic flux compression

    DOEpatents

    Lasche, G.P.

    1983-09-29

    The invention is a laser or particle-beam-driven fusion reactor system which takes maximum advantage of both the very short pulsed nature of the energy release of inertial confinement fusion (ICF) and the very small volumes within which the thermonuclear burn takes place. The pulsed nature of ICF permits dynamic direct energy conversion schemes such as magnetohydrodynamic (MHD) generation and magnetic flux compression; the small volumes permit very compact blanket geometries. By fully exploiting these characteristics of ICF, it is possible to design a fusion reactor with exceptionally high power density, high net electric efficiency, and low neutron-induced radioactivity. The invention includes a compact blanket design and method and apparatus for obtaining energy utilizing the compact blanket.

  15. Core Items for a Standardized Resource Use Measure: Expert Delphi Consensus Survey.

    PubMed

    Thorn, Joanna C; Brookes, Sara T; Ridyard, Colin; Riley, Ruth; Hughes, Dyfrig A; Wordsworth, Sarah; Noble, Sian M; Thornton, Gail; Hollingworth, William

    2018-06-01

    Resource use measurement by patient recall is characterized by inconsistent methods and a lack of validation. A validated standardized resource use measure could increase data quality, improve comparability between studies, and reduce research burden. To identify a minimum set of core resource use items that should be included in a standardized adult instrument for UK health economic evaluation from a provider perspective. Health economists with experience of UK-based economic evaluations were recruited to participate in an electronic Delphi survey. Respondents were asked to rate 60 resource use items (e.g., medication names) on a scale of 1 to 9 according to the importance of the item in a generic context. Items considered less important according to predefined consensus criteria were dropped and a second survey was developed. In the second round, respondents received the median score and their own score from round 1 for each item alongside summarized comments and were asked to rerate items. A final project team meeting was held to determine the recommended core set. Forty-five participants completed round 1. Twenty-six items were considered less important and were dropped, 34 items were retained for the second round, and no new items were added. Forty-two respondents (93.3%) completed round 2, and greater consensus was observed. After the final meeting, 10 core items were selected, with further items identified as suitable for "bolt-on" questionnaire modules. The consensus on 10 items considered important in a generic context suggests that a standardized instrument for core resource use items is feasible. Copyright © 2018. Published by Elsevier Inc.

  16. The Introduction of Key Skills in Schools: Core or Casualty?

    ERIC Educational Resources Information Center

    Glover, Derek; Gleeson, Denis; Johnson, Mike; Spencer, Pat; Watson, Ray

    2000-01-01

    Study of the introduction of generic Key Skills in two local education authorities in Britain found limited implementation. Results suggested the need for strategic district- and school-level management, clear aims and objectives, ownership by school staff, and cross-curricular application. (SK)

  17. An open-source java platform for automated reaction mapping.

    PubMed

    Crabtree, John D; Mehta, Dinesh P; Kouri, Tina M

    2010-09-27

    This article presents software applications that have been built upon a modular, open-source, reaction mapping library that can be used in both cheminformatics and bioinformatics research. We first describe the theoretical underpinnings and modular architecture of the core software library. We then describe two applications that have been built upon that core. The first is a generic reaction viewer and mapper, and the second classifies reactions according to rules that can be modified by end users with little or no programming skills.

  18. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Daling, P.M.; Marler, J.E.; Vo, T.V.

    This study evaluates the values (benefits) and impacts (costs) associated with potential resolutions to Generic Issue 143, ``Availability of HVAC and Chilled Water Systems.`` The study identifies vulnerabilities related to failures of HVAC, chilled water, and room cooling systems; develops estimates of room heatup rates and safety-related equipment vulnerabilities following losses of HVAC/room cooler systems; develops estimates of the core damage frequencies and public risks associated with failures of these systems; develops three proposed resolution strategies to this generic issue; and performs a value/impact analysis of the proposed resolutions. Existing probabilistic risk assessments for four representative plants, including one plantmore » from each vendor, form the basis for the core damage frequency and public risk calculations. Both internal and external events were considered. It was concluded that all three proposed resolution strategies exceed the $1,000/person-rem cost-effectiveness ratio. Additional evaluations were performed to develop ``generic`` insights on potential design-related and configuration-related vulnerabilities and potential high-frequency ({approximately}1E-04/RY) accident sequences that involve failures of HVAC/room cooling functions. It was concluded that, although high-frequency accident sequences may exist at some plants, these high-frequency sequences are plant-specific in nature or have been resolved through hardware and/or operational changes. The plant-specific Individual Plant Examinations are an effective vehicle for identification and resolution of these plant-specific anomalies and hardware configurations.« less

  19. New engineering: from knowledge to competences

    NASA Astrophysics Data System (ADS)

    Cartagena, M. C.; Tarquis, A. M.; Arce, A.

    2009-04-01

    One of the main innovations of Bologna system has been to link learning outcomes, ECTS workload based credits and competences. Competences represent a dynamic combination of knowledge, understanding, skills and abilities. Competences can be distinguished in subject specific and generic ones (instrumental, interpersonal and systemic competences). Actually in Spain Engineering degrees are changing to the new University educational system and should aim to satisfy the real needs of European society. This change has been long and complex, particularly. on the issue that have influenced curricular change Consultation with "actors" and "stakeholders", the definition of academic and professionals profiles and the translation of these into desired learning outcomes. Generic competences or transferable skills are relevant for preparing students well for their future role in society in terms of employability and citizenship. The criteria used by the companies to select their engineers are based in a good background and capacity to adapt and to acquire new knowledge, better than specific education, even postgraduate. It was interesting to note the great importance of generic competences However, Spanish government has regulated conditions of core curriculum need for to guarantee the acquisition of the competences needs to exercise the correspondent professional activities. The new degrees should comply with the core curriculum if the graduates want maintain the legal attributions guaranteed actually by the Spanish Professional Associations. After these degrees, students can access to professional master with actually horizontal attributions of regulated professions.

  20. Variations in response control within at-risk gamblers and non-gambling controls explained by GABAergic inhibition in the motor cortex.

    PubMed

    Chowdhury, Nahian S; Livesey, Evan J; Blaszczynski, Alex; Harris, Justin A

    2018-06-01

    Paired-pulse Transcranial Magnetic Stimulation (TMS) is used to study inhibitory and excitatory mechanisms in the motor cortex through the measurement of short-interval intracortical inhibition (SICI), indicative of GABAergic activity, and intracortical facilitation (ICF), indicative of glutamatergic activity. In the present study, TMS was delivered to the left motor cortex of 40 participants while we measured SICI and ICF at rest. We were interested in whether variation between individuals in these modulatory mechanisms is related to inhibitory control over responding measured as stop signal reaction time (SSRT). Within the same group of participants, we investigated whether SICI, ICF, SSRT, and self-reported impulsivity, are impaired in participants identified as At-Risk gamblers (n = 20) compared to non-gambling controls (n = 20). We found a significant negative correlation between SICI strength and SSRT, but no correlation between ICF strength and SSRT after controlling for the correlation between SICI and SSRT. Thus, poor inhibitory control of responding was associated with weak GABAergic activity. When taking into account the effects of substance/alcohol use and attention-deficit hyperactivity disorder (ADHD) symptom severity, At-Risk gamblers showed elevated self-reported impulsivity, but did not differ from controls on SSRT or SICI/ICF. Our study is the first to show that individual differences in motor cortex inhibition can predict stopping performance, and the first to investigate paired-pulse TMS parameters (together with other impulse control measures) in a gambling population. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. A Dutch ICF version of the Activity Inventory: results from focus groups with visually impaired persons and experts.

    PubMed

    Bruijning, Janna; van Nispen, Ruth; Verstraten, Peter; van Rens, Ger

    2010-12-01

    To develop a valid and reliable instrument to systematically investigate visual rehabilitation needs of visually impaired older adults, which is compatible with the "International Classification of Functioning, Disability and Health" (ICF) structure: a new Dutch ICF version of the Activity Inventory (D-AI). The original AI was translated, adjusted and expanded. After studying literature and investigating patient records, focus group discussions were conducted until the input was just confirmatory. Six (n = 41) and seven (n = 50) discussions with patients and professionals respectively contributed to the first draft of the D-AI, which was further improved by professionals. The D-AI now consists of 10 domains, 68 goals and 813 tasks. Goals are organized into the "Activities and Participation" domains of the ICF. The original routing was maintained; only tasks organized under important (0 [not important] to 3 [very important]) and difficult (0 [not difficult] to 4 [impossible]) goals were assessed. Rehabilitation needs can be organized in the "Activities and Participation" domains of the ICF. The D-AI offers a way of systematically assessing and measuring functional limitations and disabilities, and provides detailed information about activities that are needed to perform a certain goal. Focus group discussions with Dutch patients and experts revealed additional items that will probably be relevant for other populations. Involving patients in the first step of the developing process is important to provide face and content validity. The D-AI can prioritize rehabilitation goals by multiplying importance and difficulty scores, which is helpful in formulating a rehabilitation plan.

  2. Using the international classification of functioning, disability and health to expand understanding of paralysis in the United States through improved surveillance.

    PubMed

    Fox, Michael H; Krahn, Gloria L; Sinclair, Lisa B; Cahill, Anthony

    2015-07-01

    Surveillance on paralysis prevalence has been conceptually and methodologically challenging. Numerous methods have been used to approximate population-level paralysis prevalence estimates leading to widely divergent prevalence estimates. To describe three phases in use of the International Classification of Functioning, Disability and Health (ICF) as a framework and planning tool for defining paralysis and developing public health surveillance of this condition. Description of the surveillance methodology covers four steps: an assessment of prior data collection efforts that included a review of existing surveys, registries and other data collection efforts designed to capture both case definitions in use and prevalence of paralysis; use of a consensus conference of experts to develop a case definition of paralysis based on the ICF rather than medical diagnostic criteria; explanation of use of the ICF framework for domains of interest to develop, cognitively test, validate and administer a brief self-report questionnaire for telephone administration on a population; and development and administration of a Paralysis Prevalence and Health Disparities Survey that used content mapping to back code items from existing national surveys to operationalize key domains. ICF coding led to a national population-based survey of paralysis that produced accurate estimates of prevalence and identification of factors related to the health of people in the U.S. living with paralysis. The ICF can be a useful tool for developing valid and reliable surveillance strategies targeting subgroups of individuals with functional disabilities such as people with paralysis and others. Published by Elsevier Inc.

  3. Harmonizing routinely collected health information for strengthening quality management in health systems: requirements and practice.

    PubMed

    Prodinger, Birgit; Tennant, Alan; Stucki, Gerold; Cieza, Alarcos; Üstün, Tevfik Bedirhan

    2016-10-01

    Our aim was to specify the requirements of an architecture to serve as the foundation for standardized reporting of health information and to provide an exemplary application of this architecture. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) served as the conceptual framework. Methods to establish content comparability were the ICF Linking Rules. The Rasch measurement model, as a special case of additive conjoint measurement, which satisfies the required criteria for fundamental measurement, allowed for the development of a common metric foundation for measurement unit conversion. Secondary analysis of data from the North Yorkshire Survey was used to illustrate these methods. Patients completed three instruments and the items were linked to the ICF. The Rasch measurement model was applied, first to each scale, and then to items across scales which were linked to a common domain. Based on the linking of items to the ICF, the majority of items were grouped into two domains, Mobility and Self-care. Analysis of the individual scales and of items linked to a common domain across scales satisfied the requirements of the Rasch measurement model. The measurement unit conversion between items from the three instruments linked to the Mobility and Self-care domains, respectively, was demonstrated. The realization of an ICF-based architecture for information on patients' functioning enables harmonization of health information while allowing clinicians and researchers to continue using their existing instruments. This architecture will facilitate access to comprehensive and consistently reported health information to serve as the foundation for informed decision-making. © The Author(s) 2016.

  4. Aspects relevant for functioning in patients with ankylosing spondylitis according to the health professionals: a Delphi study with the ICF as reference.

    PubMed

    Boonen, Annelies; van Berkel, Monique; Kirchberger, Inge; Cieza, Alarcos; Stucki, Gerald; van der Heijde, Désirée

    2009-08-01

    In AS there is no agreed definition of which aspects are important when describing functioning. This limits the possibility to classify, evaluate and investigate the consequences of the disease. This study aimed to achieve consensus among health professionals on which aspects of functioning are typical and relevant for AS patients using the International Classification of Functioning, Disability and Health (ICF) as reference. An international Delphi study through e-mail was performed among different health professions. Answers to open questions on areas relevant for functioning in the first round were linked to ICF categories and analysed in the two following two rounds for the degree of consensus. Of the 267 experts invited, 126 agreed to participate and 74 participated in all rounds; 28 were rheumatologists, 6 rheumatology nurses, 24 physiotherapists, 2 occupational therapists, 4 psychologists, 8 rehabilitation physicians and 2 social workers. More than 80% agreement was reached on 141 ICF categories, of which 30 (21%) were part of Body functions; 27 (19%) of Body structures; 56 (40%) of Activities and Participation; and 28 (20%) of Environmental factors. In addition, two Personal factors-illness knowledge and coping-were agreed upon. 141 ICF categories and two personal factors represent the reference of functioning in AS from the perspective of health professional. The largest number of categories concerned restrictions in activities. Also, the impact of AS on participation in life situations and the role of environmental factors were underscored. This broadens the view on functioning in AS and has implications for future research into functioning.

  5. Battery Capacity Fading Estimation Using a Force-Based Incremental Capacity Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Samad, Nassim A.; Kim, Youngki; Siegel, Jason B.

    Traditionally health monitoring techniques in lithium-ion batteries rely on voltage and current measurements. A novel method of using a mechanical rather than electrical signal in the incremental capacity analysis (ICA) method is introduced in this paper. This method derives the incremental capacity curves based onmeasured force (ICF) instead of voltage (ICV). The force ismeasured on the surface of a cell under compression in a fixture that replicates a battery pack assembly and preloading. The analysis is performed on data collected from cycling encased prismatic Lithium-ion Nickel-Manganese-Cobalt Oxide (NMC) cells. For the NMC chemistry, the ICF method can complement or replacemore » the ICV method for the following reasons. The identified ICV peaks are centered around 40% of state of charge (SOC) while the peaks of the ICF method are centered around 70% of SOC indicating that the ICF can be used more often because it is more likely that an electric vehicle (EV) or a plug-in hybrid electric vehicle (PHEV) will traverse the 70% SOC range than the 40% SOC. In addition the Signal to Noise ratio (SNR) of the force signal is four times larger than the voltage signal using laboratory grade sensors. The proposed ICF method is shown to achieve 0.42% accuracy in capacity estimation during a low C-rate constant current discharge. Future work will investigate the application of the capacity estimation technique under charging and operation under high C-rates by addressing the transient behavior of force so that an online methodology for capacity estimation is developed.« less

  6. A descriptive study on the functioning profile of patients with spinal cord injury in a rehabilitation center in Russia.

    PubMed

    Vasilchenko, E; Escorpizo, R; Filatov, E; Kislova, A; Surodeyeva, Y; Lyachovetskaya, V; Zoloyev, G

    2017-05-01

    This is a cross-sectional study. (1) To use the International Classification of Functioning, Disability and Health (ICF) profile to assess the functioning of patients with spinal cord injury (SCI) admitted to a rehabilitation center; (2) To determine the role of the ICF in the operation of a rehabilitation center in Russia. This study was conducted in the Federal center for disability rehabilitation in Novokuznetsk, Russia. Eighty-one patients with SCI (59 men and 22 women; 31 with cervical, 41 with thoracic and 9 with lumbar level of injury) were included in the study. We determined the odds ratios of more pronounced impairments in ICF categories according to the duration of SCI and degree of neurological deficit. Mean age of patients was 34.9±11.1 years, men/women ratio was 2.7:1 and the median of time from injury was 2.5 (1.5-6) years. On the basis of American Spinal Injury Association Impairment Scale (AIS), most patients had AIS A (N=31, 38.3%). Patients with tetraplegia and AIS A or AIS B were at risk for more significant impairments in b620 'urination functions' and b640 'sexual functions'. Patients with paraplegia and AIS A or AIS B were at risk for more significant impairments in b735 'muscle tone functions'. Using the ICF, we were able to describe the range and extent of functioning problems experienced by patients with SCI who were admitted in our rehabilitation center. Moreover, the use of the ICF improved the interaction between specialists.

  7. Identification of Near-infrared [Se III] and [Kr VI] Emission Lines in Planetary Nebulae

    NASA Astrophysics Data System (ADS)

    Sterling, N. C.; Madonna, S.; Butler, K.; García-Rojas, J.; Mashburn, A. L.; Morisset, C.; Luridiana, V.; Roederer, I. U.

    2017-05-01

    We identify [Se III] 1.0994 μm in the planetary nebula (PN) NGC 5315 and [Kr VI] 1.2330 μm in three PNe from spectra obtained with the Folded-Port InfraRed Echellette (FIRE) spectrometer on the 6.5 m Baade Telescope. Se and Kr are the two most widely detected neutron-capture elements in astrophysical nebulae, and can be enriched by s-process nucleosynthesis in PN progenitor stars. The detection of [Se III] 1.0994 μm is particularly valuable when paired with observations of [Se IV] 2.2864 μm, as it can be used to improve the accuracy of nebular Se abundance determinations, and allows Se ionization correction factor (ICF) schemes to be empirically tested for the first time. We present new effective collision strength calculations for Se2+ and Kr5+, which we use to compute ionic abundances. In NGC 5315, we find that the Se abundance computed from Se3+/H+ is lower than that determined with ICFs that incorporate Se2+/H+. We compute new Kr ICFs that take Kr5+/H+ into account, by fitting correlations found in grids of Cloudy models between Kr ionic fractions and those of more abundant elements, and use these to derive Kr abundances in four PNe. Observations of [Se III] and [Kr VI] in a larger sample of PNe, with a range of excitation levels, are needed to rigorously test the ICF prescriptions for Se and our new Kr ICFs. This paper includes data obtained with the 6.5-m Magellan Telescopes at Las Campanas Observatory, Chile.

  8. Battery Capacity Fading Estimation Using a Force-Based Incremental Capacity Analysis

    DOE PAGES

    Samad, Nassim A.; Kim, Youngki; Siegel, Jason B.; ...

    2016-05-27

    Traditionally health monitoring techniques in lithium-ion batteries rely on voltage and current measurements. A novel method of using a mechanical rather than electrical signal in the incremental capacity analysis (ICA) method is introduced in this paper. This method derives the incremental capacity curves based onmeasured force (ICF) instead of voltage (ICV). The force ismeasured on the surface of a cell under compression in a fixture that replicates a battery pack assembly and preloading. The analysis is performed on data collected from cycling encased prismatic Lithium-ion Nickel-Manganese-Cobalt Oxide (NMC) cells. For the NMC chemistry, the ICF method can complement or replacemore » the ICV method for the following reasons. The identified ICV peaks are centered around 40% of state of charge (SOC) while the peaks of the ICF method are centered around 70% of SOC indicating that the ICF can be used more often because it is more likely that an electric vehicle (EV) or a plug-in hybrid electric vehicle (PHEV) will traverse the 70% SOC range than the 40% SOC. In addition the Signal to Noise ratio (SNR) of the force signal is four times larger than the voltage signal using laboratory grade sensors. The proposed ICF method is shown to achieve 0.42% accuracy in capacity estimation during a low C-rate constant current discharge. Future work will investigate the application of the capacity estimation technique under charging and operation under high C-rates by addressing the transient behavior of force so that an online methodology for capacity estimation is developed.« less

  9. Framework Thinking, Subject Thinking and "Taiwan-"ness"" in Environmental Education

    ERIC Educational Resources Information Center

    Yueh, Mei-Chun Michelle; Barker, Miles

    2011-01-01

    In the 1998 Taiwanese national curriculum revision, environmental education was one of six new "Important Issues". To some early observers, the generic "framework" sections of this 1998 curriculum (Aims, Goals, Core Competences) resonated well with the integrative and transdisciplinary nature of environmental education. This…

  10. LANL Q2 2016 Quarterly Progress Report. Science Campaign and ICF

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Douglas, Melissa Rae

    2016-04-07

    This progress report includes highlights for the Science Campaign and ICF about Advanced Certification and Assessment Methodologies, Implosion Hydrodynamics (C-1, SCE), Materials and Nuclear Science (C-1, C-2), Capabilities for Nuclear Intelligence, and High Energy Density Science (C-1, C-4, C-10). Upcoming meetings, briefings, and experiments are then listed for April and May.

  11. Using the International Classification of Functioning, Disability and Health in Assessment and Intervention of School-Aged Children with Language Impairments

    ERIC Educational Resources Information Center

    Westby, Carol; Washington, Karla N.

    2017-01-01

    Purpose: The aim of this tutorial is to support speech-language pathologists' (SLPs') application of the International Classification of Functioning, Disability and Health (ICF) in assessment and treatment practices with children with language impairment. Method: This tutorial reviews the framework of the ICF, describes the implications of the ICF…

  12. Research and Implementation Issues in Developing a Reimbursement System for ICFs/MR Program Costs Based on Client Resource Use.

    ERIC Educational Resources Information Center

    Chapin, Rosemary; Rotegard, Lisa

    Under the current Medicaid reimbursement system in Minnesota for intermediate care facilities for the mentally retarded (ICFs/MR), payments are not targeted properly because there is no uniform assessment and resource use information to determine those clients for whom services are most costly to provide. A project was mandated by the state…

  13. Satisfaction and Sense of Well Being among Medicaid ICF/MR and HCBS Recipients in Six States

    ERIC Educational Resources Information Center

    Stancliffe, Roger J.; Lakin, K. Charlie; Taub, Sarah; Chiri, Giuseppina; Byun, Soo-yong

    2009-01-01

    Self-reported satisfaction and sense of well-being were assessed in a sample of 1,885 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services in 6 states. Questions dealt with such topics as loneliness, feeling afraid at home and in one's…

  14. Break the Data-Bank with Monte Carlo? Statistical Problems in the Dispute between Conroy (1996) and Crinella, McCleary, and Swanson (1998).

    ERIC Educational Resources Information Center

    Heifetz, Louis J.

    1998-01-01

    Comments on "The Small ICF/MR Program: Dimensions of Quality and Cost" (Conroy), that found small Intermediate Care Facilities (ICF) for individuals with mental retardation are inferior to other community programs. Acknowledges that while some research problems exist, no important evidence against the findings has been provided. (CR)

  15. Intermediate Care Facilities for Persons with Mental Retardation (ICFs-MR): Program Utilization and Resident Characterstics. Project Report #31.

    ERIC Educational Resources Information Center

    Minnesota Univ., Minneapolis. Center for Residential and Community Services.

    This report on the Intermediate Care Facility for the Mentally Retarded (ICF-MR) and related programs under Title XIX (Medicaid) of the Social Security Act aims to assist in consideration of improvements to Medicaid services. The report begins with a background description of the key Medicaid programs of interest, discussing: federal involvement…

  16. 42 CFR 418.112 - Condition of participation: Hospices that provide hospice care to residents of a SNF/NF or ICF/MR.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...; counseling (including spiritual, dietary and bereavement); social work; provision of medical supplies... hospice must: (1) Designate a member of each interdisciplinary group that is responsible for a patient who is a resident of a SNF/NF or ICF/MR. The designated interdisciplinary group member is responsible for...

  17. The Impact of Speech Impairment in Early Childhood: Investigating Parents' and Speech-Language Pathologists' Perspectives Using the ICF-CY

    ERIC Educational Resources Information Center

    McCormack, Jane; McLeod, Sharynne; Harrison, Linda J.; McAllister, Lindy

    2010-01-01

    Purpose: To explore the application of the Activities and Participation component of the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY, World Health Organization, 2007) as a framework for investigating the perceived impact of speech impairment in childhood. Method: A 32-item questionnaire based on…

  18. 42 CFR 456.603 - Financial interests and employment of team members.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Financial interests and employment of team members... of team members. (a) Except as provided in paragraph (b) of this section— (1) [Reserved] (2) No member of a team that reviews care in an ICF may have a financial interest in or be employed by any ICF...

  19. 42 CFR 456.603 - Financial interests and employment of team members.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Financial interests and employment of team members... of team members. (a) Except as provided in paragraph (b) of this section— (1) [Reserved] (2) No member of a team that reviews care in an ICF may have a financial interest in or be employed by any ICF...

  20. 42 CFR 456.603 - Financial interests and employment of team members.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Financial interests and employment of team members... of team members. (a) Except as provided in paragraph (b) of this section— (1) [Reserved] (2) No member of a team that reviews care in an ICF may have a financial interest in or be employed by any ICF...

  1. 42 CFR 456.603 - Financial interests and employment of team members.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Financial interests and employment of team members... of team members. (a) Except as provided in paragraph (b) of this section— (1) [Reserved] (2) No member of a team that reviews care in an ICF may have a financial interest in or be employed by any ICF...

  2. 42 CFR 456.603 - Financial interests and employment of team members.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Financial interests and employment of team members... of team members. (a) Except as provided in paragraph (b) of this section— (1) [Reserved] (2) No member of a team that reviews care in an ICF may have a financial interest in or be employed by any ICF...

  3. Improved AFM Mapping of ICF Target Surfaces

    NASA Astrophysics Data System (ADS)

    Olson, D. K.; Drake, T.; Frey, D.; Huang, H.; Stephens, R. B.

    2003-10-01

    Targets for Inertial Confinement Fusion (ICF) research are made from spherical shells with very strict requirements on surface smoothness. Hydrodynamic instabilities are amplified by the presence of surface defects, greatly reducing the gain of ICF targets. Sub-micron variations in the surface can be examined using an Atomic Force Microscope. The current sphere mapping assembly at General Atomics is designed to trace near the equator of a rotating sphere under the AFM head. Spheres are traced on three mutually orthogonal planes. The ˜10 mm piezo-electric actuator range limits how far off the equator we can scan spheres of millimeter diameter. Because only a small fraction of the target's surface can be covered, localized high-mode defects are difficult to detect. In order to meet the needs of ICF research, we need to scan more surface area of the sphere with the AFM. By integrating an additional stepping motor to the sphere mapping assembly, we will be able to recenter the piezo driver of the AFM while mapping. This additional ability allows us to increase the amount of the sphere's surface we are able to scan with the AFM by extending the range of the AFM from the sphere's equator.

  4. A tool to enhance occupational therapy reasoning from ICF perspective: The Hasselt Occupational Performance Profile (H-OPP).

    PubMed

    Ghysels, R; Vanroye, E; Westhovens, M; Spooren, A

    2017-03-01

    In order to enhance occupational therapy reasoning in clinical practice, different elements such as client-centred approach, evidence-based care and interdisciplinary work should be taken into account, but is a challenge. To describe the development of the digital Hasselt Occupational Performance Profile (H-OPP © ) that enhances occupational therapy reasoning from ICF perspective. A participative qualitative design was used to create the H-OPP © in an iterative way in which occupational therapy lectures, ICF experts, students and occupational therapists in the field were involved. After linking occupational therapy terminology to the ICF, different stages of the H-OPP were identified and elaborated with main features: generating an occupational performance profile based on inventarization of problems and possibilities, formulating an occupational performance diagnosis and enabling to create an intervention plan. In all stages, both the perspectives of the client and the occupational therapist were taken into account. To increase practical use, the tool was further elaborated and digitalized. The H-OPP © is a digital coach that guides and facilitates professional reasoning in (novice) occupational therapists. It augments involvement of the client system. Furthermore, it enhances interdisciplinary communication and evidence-based care.

  5. Ion kinetic dynamics in strongly-shocked plasmas relevant to ICF

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rinderknecht, H. G.; Amendt, P. A.; Rosenberg, M. J.

    Implosions of thin-shell capsules produce strongly-shocked (M > 10), low-density (ρ ~1 mg/cc -1), high-temperature (T i ~keV) plasmas, comparable to those produced in the strongly-shocked DT-vapor in inertial confinement fusion (ICF) experiments. A series of thin-glass targets filled with mixtures of deuterium and Helium-3 gas ranging from 7% to 100% deuterium was imploded to investigate the impact of multi-species ion kinetic mechanisms in ICF-relevant plasmas over a wide range of Knudsen numbers (N K ≡ λ ii/R). Anomalous trends in nuclear yields and burn-averaged ion temperatures in implosions with N K > 0.5, which have been interpreted as signaturesmore » of ion species separation and ion thermal decoupling, are found not to be consistent with single-species ion kinetic effects alone. Experimentally inferred Knudsen numbers predict an opposite yield trend to those observed, confirming the dominance of multi-species physics in these experiments. In contrast, implosions with N K ~ 0.01 follow the expected yield trend, suggesting single-species kinetic effects are dominant. In conclusion, the impact of the observed kinetic physics mechanisms on the formation of the hotspot in ICF experiments is discussed.« less

  6. Kinetic physics in ICF: present understanding and future directions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rinderknecht, Hans G.; Amendt, P. A.; Wilks, S. C.

    Kinetic physics has the potential to impact the performance of indirect-drive inertial confinement fusion (ICF) experiments. Systematic anomalies in the National Ignition Facility implosion dataset have been identified in which kinetic physics may play a role, including inferred missing energy in the hohlraum, drive asymmetry in near-vacuum hohlraums, low areal density and high burn-averaged ion temperatures (T i ) compared with mainline simulations, and low ratios of the DD-neutron and DT-neutron yields and inferred T i . Several components of ICF implosions are likely to be influenced or dominated by kinetic physics: laser-plasma interactions in the LEH and hohlraum interior;more » the hohlraum wall blowoff, blowoff/gas and blowoff/ablator interfaces; the ablator and ablator/ice interface; and the DT fuel all present conditions in which kinetic physics can significantly affect the dynamics. This review presents the assembled experimental data and simulation results to date, which indicate that the effects of long mean-free-path plasma phenomena and self-generated electromagnetic fields may have a significant impact in ICF targets. Finally, simulation and experimental efforts are proposed to definitively quantify the importance of these effects at ignition-relevant conditions, including priorities for ongoing study.« less

  7. Kinetic physics in ICF: present understanding and future directions

    DOE PAGES

    Rinderknecht, Hans G.; Amendt, P. A.; Wilks, S. C.; ...

    2018-03-19

    Kinetic physics has the potential to impact the performance of indirect-drive inertial confinement fusion (ICF) experiments. Systematic anomalies in the National Ignition Facility implosion dataset have been identified in which kinetic physics may play a role, including inferred missing energy in the hohlraum, drive asymmetry in near-vacuum hohlraums, low areal density and high burn-averaged ion temperatures (T i ) compared with mainline simulations, and low ratios of the DD-neutron and DT-neutron yields and inferred T i . Several components of ICF implosions are likely to be influenced or dominated by kinetic physics: laser-plasma interactions in the LEH and hohlraum interior;more » the hohlraum wall blowoff, blowoff/gas and blowoff/ablator interfaces; the ablator and ablator/ice interface; and the DT fuel all present conditions in which kinetic physics can significantly affect the dynamics. This review presents the assembled experimental data and simulation results to date, which indicate that the effects of long mean-free-path plasma phenomena and self-generated electromagnetic fields may have a significant impact in ICF targets. Finally, simulation and experimental efforts are proposed to definitively quantify the importance of these effects at ignition-relevant conditions, including priorities for ongoing study.« less

  8. Kinetic physics in ICF: present understanding and future directions

    NASA Astrophysics Data System (ADS)

    Rinderknecht, Hans G.; Amendt, P. A.; Wilks, S. C.; Collins, G.

    2018-06-01

    Kinetic physics has the potential to impact the performance of indirect-drive inertial confinement fusion (ICF) experiments. Systematic anomalies in the National Ignition Facility implosion dataset have been identified in which kinetic physics may play a role, including inferred missing energy in the hohlraum, drive asymmetry in near-vacuum hohlraums, low areal density and high burn-averaged ion temperatures (〈Ti 〉) compared with mainline simulations, and low ratios of the DD-neutron and DT-neutron yields and inferred 〈Ti 〉. Several components of ICF implosions are likely to be influenced or dominated by kinetic physics: laser-plasma interactions in the LEH and hohlraum interior; the hohlraum wall blowoff, blowoff/gas and blowoff/ablator interfaces; the ablator and ablator/ice interface; and the DT fuel all present conditions in which kinetic physics can significantly affect the dynamics. This review presents the assembled experimental data and simulation results to date, which indicate that the effects of long mean-free-path plasma phenomena and self-generated electromagnetic fields may have a significant impact in ICF targets. Simulation and experimental efforts are proposed to definitively quantify the importance of these effects at ignition-relevant conditions, including priorities for ongoing study.

  9. Medicaid program; correction and reduction plans for intermediate care facilities for the mentally retarded--HCFA. Final rule.

    PubMed

    1991-07-05

    This final rule amends the portions of the Medicaid regulations under which an intermediate care facility for the mentally retarded (ICF/MR) with substantial deficiencies that did not pose an immediate jeopardy to the health and safety of clients could continue participation in the Medicaid program. These regulations gave State Medicaid agencies the option of submitting written plans to either correct deficiencies or permanently reduce the number of beds in the certified portion of the facility. This rule removes all requirements for submitting, approving, and monitoring correction plans for ICFs/MR. The requirements for submitting and approving correction plans are being removed because the time limit for submission of these plans has passed. The provisions for monitoring correction plans are being removed because there are no remaining facilities for which these provisions apply. This final rule also removes requirements for submitting and approving reduction plans for ICFs/MR because the time limit for submitting these plans has passed. It retains and updates the requirements for monitoring and compliance that apply to those ICFs/MR for which reduction plans were approved by January 1, 1990.

  10. Ion kinetic dynamics in strongly-shocked plasmas relevant to ICF

    DOE PAGES

    Rinderknecht, H. G.; Amendt, P. A.; Rosenberg, M. J.; ...

    2017-04-20

    Implosions of thin-shell capsules produce strongly-shocked (M > 10), low-density (ρ ~1 mg/cc -1), high-temperature (T i ~keV) plasmas, comparable to those produced in the strongly-shocked DT-vapor in inertial confinement fusion (ICF) experiments. A series of thin-glass targets filled with mixtures of deuterium and Helium-3 gas ranging from 7% to 100% deuterium was imploded to investigate the impact of multi-species ion kinetic mechanisms in ICF-relevant plasmas over a wide range of Knudsen numbers (N K ≡ λ ii/R). Anomalous trends in nuclear yields and burn-averaged ion temperatures in implosions with N K > 0.5, which have been interpreted as signaturesmore » of ion species separation and ion thermal decoupling, are found not to be consistent with single-species ion kinetic effects alone. Experimentally inferred Knudsen numbers predict an opposite yield trend to those observed, confirming the dominance of multi-species physics in these experiments. In contrast, implosions with N K ~ 0.01 follow the expected yield trend, suggesting single-species kinetic effects are dominant. In conclusion, the impact of the observed kinetic physics mechanisms on the formation of the hotspot in ICF experiments is discussed.« less

  11. Three-dimensional modeling of the neutron spectrum to infer plasma conditions in cryogenic inertial confinement fusion implosions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weilacher, F.; Radha, P. B.; Forrest, C.

    Neutron-based diagnostics are typically used to infer compressed core conditions such as areal density and ion temperature in deuterium–tritium (D–T) inertial confinement fusion (ICF) implosions. Asymmetries in the observed neutron-related quantities are important to understanding failure modes in these implosions. Neutrons from fusion reactions and their subsequent interactions including elastic scattering and neutron-induced deuteron breakup reactions are tracked to create spectra. Here, it is shown that background subtraction is important for inferring areal density from backscattered neutrons and is less important for the forward-scattered neutrons. A three-dimensional hydrodynamic simulation of a cryogenic implosion on the OMEGA Laser System [T. R.more » Boehly et al., Opt. Commun. 133, 495 (1997)] using the hydrodynamic code HYDRA [M. M. Marinak et al., Phys. Plasmas 8, 2275 (2001)] is post-processed using the tracking code IRIS3D. It is shown that different parts of the neutron spectrum from the view can be mapped into different regions of the implosion, enabling an inference of an areal-density map. It is also shown that the average areal-density and an areal-density map of the compressed target can be reconstructed with a finite number of detectors placed around the target chamber. Ion temperatures are inferred from the width of the D–D and D–T fusion neutron spectra. Backgrounds can significantly alter the inferred ion temperatures from the D–D reaction, whereas they insignificantly influence the inferred D–T ion temperatures for the areal densities typical of OMEGA implosions. Asymmetries resulting in fluid flow in the core are shown to influence the absolute inferred ion temperatures from both reactions, although relative inferred values continue to reflect the underlying asymmetry pattern. The work presented here is part of the wide range of the first set of studies performed with IRIS3D. Finally, this code will continue to be used for post-processing detailed hydrodynamic simulations and interpreting observed neutron spectra in ICF implosions.« less

  12. Three-dimensional modeling of the neutron spectrum to infer plasma conditions in cryogenic inertial confinement fusion implosions

    DOE PAGES

    Weilacher, F.; Radha, P. B.; Forrest, C.

    2018-04-26

    Neutron-based diagnostics are typically used to infer compressed core conditions such as areal density and ion temperature in deuterium–tritium (D–T) inertial confinement fusion (ICF) implosions. Asymmetries in the observed neutron-related quantities are important to understanding failure modes in these implosions. Neutrons from fusion reactions and their subsequent interactions including elastic scattering and neutron-induced deuteron breakup reactions are tracked to create spectra. Here, it is shown that background subtraction is important for inferring areal density from backscattered neutrons and is less important for the forward-scattered neutrons. A three-dimensional hydrodynamic simulation of a cryogenic implosion on the OMEGA Laser System [T. R.more » Boehly et al., Opt. Commun. 133, 495 (1997)] using the hydrodynamic code HYDRA [M. M. Marinak et al., Phys. Plasmas 8, 2275 (2001)] is post-processed using the tracking code IRIS3D. It is shown that different parts of the neutron spectrum from the view can be mapped into different regions of the implosion, enabling an inference of an areal-density map. It is also shown that the average areal-density and an areal-density map of the compressed target can be reconstructed with a finite number of detectors placed around the target chamber. Ion temperatures are inferred from the width of the D–D and D–T fusion neutron spectra. Backgrounds can significantly alter the inferred ion temperatures from the D–D reaction, whereas they insignificantly influence the inferred D–T ion temperatures for the areal densities typical of OMEGA implosions. Asymmetries resulting in fluid flow in the core are shown to influence the absolute inferred ion temperatures from both reactions, although relative inferred values continue to reflect the underlying asymmetry pattern. The work presented here is part of the wide range of the first set of studies performed with IRIS3D. Finally, this code will continue to be used for post-processing detailed hydrodynamic simulations and interpreting observed neutron spectra in ICF implosions.« less

  13. Applying the International Classification of Functioning, Disability and Health to guide home health care services planning and delivery in Thailand.

    PubMed

    Pimdee, Atipong; Nualnetr, Nomjit

    2017-01-01

    Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members. Patients and their caregivers were also satisfied with the services. In conclusion, the ICF is an effective means of guiding home health care.

  14. [Social participation and vocational integration as an objective of child and adolescent psychiatric rehabilitation].

    PubMed

    Voll, Renate

    2009-09-01

    In order to avoid threatening social disintegration, it is important for children and adolescents with chronic mental disorders and also for physically disabled children to diagnose disturbances of social participation in an early stage and to commence rehabilitation measures. The need for rehabilitation, the ability to rehabilitate and the rehabilitation prognosis are important for identifying the individual rehabilitation goals. A multi-axial diagnosis according to the ICF with a determination of adaptability, a behavioural analysis, skills, activity and participation is required. For disabled children, there are only a few ICF check lists for diagnosing social participation. Because of this, the ICF check list CASP (Child & Adolescent Scale of Participation) for measuring social participation according to Bedell was translated, which is shown in the appendix.

  15. Resource use and cost implications of switching among warfarin formulations in atrial fibrillation patients.

    PubMed

    Kwong, Winghan Jacqueline; Kamat, Siddhesh; Fang, Christy

    2012-12-01

    Despite the uncertainty surrounding the safety of switching warfarin formulations, limited data exist on the resource use and costs associated with this switching pattern. To evaluate health care resource use and costs associated with switching warfarin formulations among patients with atrial fibrillation (AF) in a managed care organization. Patients diagnosed with AF (ICD-9 427.31) between July 2004 and August 2008 and who received warfarin therapy were identified in the HealthCore Integrated Research Database and categorized into 3 groups: users of generic warfarin formulations from a single drug manufacturer (generic-only group), users of branded warfarin formulations only (brand-only group), and patients who used generic and branded warfarin therapy interchangeably or who may have used generic drugs from 1 or more manufacturers (generic/brand switching group). Patients were followed 12 months or longer after their index warfarin prescription date to compare all-cause resource use and costs using multivariable regression analysis. The analysis included 12,908 patients: 71.82% were in the genericonly group, 9.61% were in the brand-only group, and 18.57% were in the generic/brand switching group. Patients in the generic/brand switching group were more likely to be hospitalized (relative risk [RR] = 1.43, p < 0.0001) or to use emergency department services (RR = 1.20, p < 0.01), compared to the brand-only users. Hospitalizations were more likely (RR = 1.26, p < 0.001) to occur among generic-only users versus brand-only users. Adjusted mean pharmacy costs per member per month were lower in the generic/brand switching group compared to the brand-only group ($257 vs $273, p = 0.038), but inpatient costs were higher ($1250 vs $972, p < 0.001), resulting in higher ($2125 vs $1847, p < 0.001) total costs. Generic-only users had lower pharmacy costs compared to brand-only users ($246 vs $273, p < 0.001), but total health care costs trended to be higher in the generic-only group ($1957 vs $1847, p = 0.053). The use of both generic and branded formulations of warfarin interchangeably, or the use of generics from more than 1 manufacturer, was associated with increased use of all-cause health care resources and total costs in patients with AF.

  16. Using Generic Examples to Make Viable Arguments

    ERIC Educational Resources Information Center

    Adams, Anne E.; Ely, Rob; Yopp, David

    2017-01-01

    The twenty-first century has seen an increased call to train students to craft mathematical arguments. The third of the Common Core's (CCSS) Standards for Mathematical Practice (SMP 3) (CCSSI 2010) calls for all mathematically proficient students to "construct viable arguments" to support the truth of their ideas and to "critique…

  17. [Cognitive-behaviour therapy of schizophrenia].

    PubMed

    Keegan, Eduardo; Garay, Cristian Javier

    2007-01-01

    Cognitive-behaviour therapy is one of the evidence-based psychotherapies that have been successfully applied to the treatment of patients with psychotic symptoms. The article presents the core principles and objectives of cognitive models and interventions, and describes the generic steps of treatment. The results of the most methodologically-sound outcome studies are presented.

  18. First beryllium capsule implosions on the National Ignition Facility

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kline, J. L.; Yi, S. A.; Simakov, A. N.

    2016-05-15

    The first indirect drive implosion experiments using Beryllium (Be) capsules at the National Ignition Facility confirm the superior ablation properties and elucidate possible Be-ablator issues such as hohlraum filling by ablator material. Since the 1990s, Be has been the preferred Inertial Confinement Fusion (ICF) ablator because of its higher mass ablation rate compared to that of carbon-based ablators. This enables ICF target designs with higher implosion velocities at lower radiation temperatures and improved hydrodynamic stability through greater ablative stabilization. Recent experiments to demonstrate the viability of Be ablator target designs measured the backscattered laser energy, capsule implosion velocity, core implosionmore » shape from self-emission, and in-flight capsule shape from backlit imaging. The laser backscatter is similar to that from comparable plastic (CH) targets under the same hohlraum conditions. Implosion velocity measurements from backlit streaked radiography show that laser energy coupling to the hohlraum wall is comparable to plastic ablators. The measured implosion shape indicates no significant reduction of laser energy from the inner laser cone beams reaching the hohlraum wall as compared with plastic and high-density carbon ablators. These results indicate that the high mass ablation rate for beryllium capsules does not significantly alter hohlraum energetics. In addition, these data, together with data for low fill-density hohlraum performance, indicate that laser power multipliers, required to reconcile simulations with experimental observations, are likely due to our limited understanding of the hohlraum rather than the capsule physics since similar multipliers are needed for both Be and CH capsules as seen in experiments.« less

  19. First beryllium capsule implosions on the National Ignition Facility

    DOE PAGES

    Kline, J. L.; Yi, S. A.; Simakov, A. N.; ...

    2016-05-01

    The first indirect drive implosion experiments using Beryllium (Be) capsules at the National Ignition Facility confirm the superior ablation properties and elucidate possible Be-ablator issues such as hohlraum filling by ablator material. Since the 1990s, Be has been the preferred Inertial Confinement Fusion (ICF) ablator because of its higher mass ablation rate compared to that of carbon-based ablators. This enables ICF target designs with higher implosion velocities at lower radiation temperatures and improved hydrodynamic stability through greater ablative stabilization. Recent experiments to demonstrate the viability of Be ablator target designs measured the backscattered laser energy, capsule implosion velocity, core implosionmore » shape from self-emission, and in-flight capsule shape from backlit imaging. The laser backscatter is similar to that from comparable plastic (CH) targets under the same hohlraum conditions. Implosion velocity measurements from backlit streaked radiography show that laser energy coupling to the hohlraum wall is comparable to plastic ablators. The measured implosion shape indicates no significant reduction of laser energy from the inner laser cone beams reaching the hohlraum wall as compared with plastic and high-density carbon ablators. These results indicate that the high mass ablation rate for beryllium capsules does not significantly alter hohlraum energetics. In addition, these data, together with data for low fill-density hohlraum performance, indicate that laser power multipliers, required to reconcile simulations with experimental observations, are likely due to our limited understanding of the hohlraum rather than the capsule physics since similar multipliers are needed for both Be and CH capsules as seen in experiments.« less

  20. Modeling of Whole-Body Response to Windblast

    DTIC Science & Technology

    1983-10-01

    RECORD IS "ROCKET OFF" DATA JDUNIT = 1 REWIND IDUNIT READ (IDUNIT) ICF NFIRE * 1 DA = 5.0*RADIAN DB1 » 5.0*RADIAN DB2 = 15.©«RADIAN DV = 0.3*SSOUND...VI * 0.6*SSOUND IF (NFIRE.EQ.0) GO TO 12 IF (TBSR.GT.0.0) GO TO 12 READ (IDUNIT) ICF NFIRE * 0 11 C ** COMPUTE INDEX AND WEIGHTS FOR ALPHA

  1. Surveying Unstructured Time of Adults with Mental Retardation Living in Two Community Settings: A Search for Normalization.

    ERIC Educational Resources Information Center

    Pierce, Thomas B., Jr.; And Others

    1990-01-01

    A survey assessed time spent in the community and/or on unstructured activities by randomly selected individuals in Intermediate Care Facilities for the Mentally Retarded (ICF/MR) (N=20) or minigroup home settings (N=20). Individuals in ICF/MR homes spent more time in the community with staff and made fewer choices of unstructured activities.…

  2. A Comparative Analysis of the Functional Disability Levels of Adult Day Care, Adult Day Health and ICF-Level Nursing Home Elderly in Hawaii.

    ERIC Educational Resources Information Center

    Hayashida, Cullen T.

    This study compared the functional disability levels of participants in adult day centers with patients in intermediate care facilities (ICFs). A three-page questionnaire measuring demographics, social resources, physical health, mental health, and activities of daily living as assessed by the Activities of Daily Living scale and the Instrumental…

  3. Site support program plan for ICF Kaiser Hanford Company, Revision 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1995-10-01

    This document is the general administrative plan implemented by the Hanford Site contractor, ICF Kaiser Hanford Company. It describes the mission, administrative structure, projected staffing, to be provided by the contractor. The report breaks out the work responsibilities within the different units of the company, a baseline schedule for the different groups, and a cost summary for the different operating units.

  4. How the Use of the International Classification of Functioning, Disability and Health for Children and Youth Changed the Individualized Education Programs in Portugal

    ERIC Educational Resources Information Center

    Silveira-Maia, Mónica; Lopes-dos-Santos, Pedro; Sanches-Ferreira, Manuela

    2017-01-01

    Current Portuguese Public Law No. 3/2008 requires the use of the International Classification of Functioning, Health and Disability for Children and Youth (ICF-CY) as a reference framework to guide assessment and intervention procedures for students with additional support needs. This study explores whether the ICF-CY use fostered multidimensional…

  5. First-principles thermal conductivity of warm-dense deuterium plasmas for inertial confinement fusion applications.

    PubMed

    Hu, S X; Collins, L A; Boehly, T R; Kress, J D; Goncharov, V N; Skupsky, S

    2014-04-01

    Thermal conductivity (κ) of both the ablator materials and deuterium-tritium (DT) fuel plays an important role in understanding and designing inertial confinement fusion (ICF) implosions. The extensively used Spitzer model for thermal conduction in ideal plasmas breaks down for high-density, low-temperature shells that are compressed by shocks and spherical convergence in imploding targets. A variety of thermal-conductivity models have been proposed for ICF hydrodynamic simulations of such coupled and degenerate plasmas. The accuracy of these κ models for DT plasmas has recently been tested against first-principles calculations using the quantum molecular-dynamics (QMD) method; although mainly for high densities (ρ > 100 g/cm3), large discrepancies in κ have been identified for the peak-compression conditions in ICF. To cover the wide range of density-temperature conditions undergone by ICF imploding fuel shells, we have performed QMD calculations of κ for a variety of deuterium densities of ρ = 1.0 to 673.518 g/cm3, at temperatures varying from T = 5 × 103 K to T = 8 × 106 K. The resulting κQMD of deuterium is fitted with a polynomial function of the coupling and degeneracy parameters Γ and θ, which can then be used in hydrodynamic simulation codes. Compared with the "hybrid" Spitzer-Lee-More model currently adopted in our hydrocode lilac, the hydrosimulations using the fitted κQMD have shown up to ∼20% variations in predicting target performance for different ICF implosions on OMEGA and direct-drive-ignition designs for the National Ignition Facility (NIF). The lower the adiabat of an imploding shell, the more variations in predicting target performance using κQMD. Moreover, the use of κQMD also modifies the shock conditions and the density-temperature profiles of the imploding shell at early implosion stage, which predominantly affects the final target performance. This is in contrast to the previous speculation that κQMD changes mainly the inside ablation process during the hot-spot formation of an ICF implosion.

  6. 7Li-induced reaction on natMo: A study of complete versus incomplete fusion

    NASA Astrophysics Data System (ADS)

    Kumar, Deepak; Maiti, Moumita; Lahiri, Susanta

    2017-07-01

    Background: Several investigations on the complete-incomplete fusion (CF-ICF) dynamics of α -cluster well-bound nuclei have been contemplated above the Coulomb barrier (˜4 -7 MeV/nucleon) in recent years. It is therefore expected to observe significant ICF over CF in the reactions induced by a weakly bound α -cluster nucleus at slightly above the barrier. Purpose: Study of the CF-ICF dynamics by measuring the populated residues in the weakly bound 7Li+natMo system at energies slightly above the Coulomb barrier to well above it. Method: In order to investigate CF-ICF in the loosely bound system, 7Li beam was bombarded on the natMo foils, separated by the aluminium (Al) catcher foils alternatively, within ˜3 -6.5 MeV/nucleon. Evaporation residues produced in each foil were identified by the off-line γ -ray spectrometry. Measured cross section data of the residues were compared with the theoretical model calculations based on the equilibrium (EQ) and pre-equilibrium (PEQ) reaction mechanisms. Results: The experimental cross section of Rh 101 m,100 ,99 m,97 ,Ru,9597,Tc 99 m,96 ,95 ,94 ,93 m+g , and 93mMo residues measured at various projectile energies were satisfactorily reproduced by the simplified coupled channel approach in comparison to single barrier penetration model calculation. Significant cross section enhancement in the α -emitting channels was observed compared to EQ and PEQ model calculations throughout observed energy region. The ICF process over CF was analyzed by comparing with EMPIRE. The increment of the incomplete fusion fraction was observed with increasing projectile energies. Conclusions: Theoretical model calculations reveal that the compound reaction mechanism is the major contributor to the production of residues in 7Li+natMo reaction. Theoretical evaluations substantiate the contribution of ICF over the CF in α -emitting channels. EMPIRE estimations shed light on its predictive capability of cross sections of the residues from the heavy-ion induced reactions.

  7. Informed Consent to Study Purpose in Randomized Clinical Trials of Antibiotics, 1991 Through 2011.

    PubMed

    Doshi, Peter; Hur, Peter; Jones, Mark; Albarmawi, Husam; Jefferson, Tom; Morgan, Daniel J; Spears, Patricia A; Powers, John H

    2017-10-01

    Potential research participants may assume that randomized trials comparing new interventions with older interventions always hypothesize greater efficacy for the new intervention, as in superiority trials. However, antibiotic trials frequently use "noninferiority" hypotheses allowing a degree of inferior efficacy deemed "clinically acceptable" compared with an older effective drug, in exchange for nonefficacy benefits (eg, decreased adverse effects). Considering these different benefit-harm trade-offs, proper informed consent necessitates supplying different information on the purposes of superiority and noninferiority trials. To determine the degree to which the study purpose is explained to potential participants in randomized clinical trials of antibiotics and the degree to which study protocols justify their selection of noninferiority hypotheses and amount of "clinically acceptable" inferiority. Cross-sectional analysis of study protocols, statistical analysis plans (SAPs), and informed consent forms (ICFs) from clinical study reports submitted to the European Medicines Agency. The ICFs were read by both methodologists and patient investigators. Protocols and SAPs were used as the reference standard to determine prespecified primary hypothesis and record rationale for selection of noninferiority hypotheses and noninferiority margins. This information was cross-referenced against ICFs to determine whether ICFs explained the study purpose. We obtained trial documents from 78 randomized trials with prespecified efficacy hypotheses (6 superiority, 72 noninferiority) for 17 antibiotics conducted between 1991 and 2011 that enrolled 39 407 patients. Fifty were included in the ICF analysis. All ICFs contained sections describing study purpose; however, none consistently conveyed study hypothesis to both methodologists and patient investigators. Methodologists found that 1 of 50 conveyed a study purpose. Patient investigators found that 11 of 50 conveyed a study purpose, 7 accurately and 4 inaccurately compared with the reference standard. Seventy-one of 72 noninferiority trial protocols or SAPs provided no rationale for selection of noninferiority hypothesis. None provided a clinical rationale for the chosen amount of decreased efficacy. Patients were not accurately informed of study purpose, which raises questions regarding the ethics of informed consent in antibiotic trials. Noninferiority and superiority trials entail different benefit-harm trade-offs that must be conveyed for ethical informed consent.

  8. First-principles thermal conductivity of warm-dense deuterium plasmas for inertial confinement fusion applications

    NASA Astrophysics Data System (ADS)

    Hu, S. X.; Collins, L. A.; Boehly, T. R.; Kress, J. D.; Goncharov, V. N.; Skupsky, S.

    2014-04-01

    Thermal conductivity (κ) of both the ablator materials and deuterium-tritium (DT) fuel plays an important role in understanding and designing inertial confinement fusion (ICF) implosions. The extensively used Spitzer model for thermal conduction in ideal plasmas breaks down for high-density, low-temperature shells that are compressed by shocks and spherical convergence in imploding targets. A variety of thermal-conductivity models have been proposed for ICF hydrodynamic simulations of such coupled and degenerate plasmas. The accuracy of these κ models for DT plasmas has recently been tested against first-principles calculations using the quantum molecular-dynamics (QMD) method; although mainly for high densities (ρ > 100 g/cm3), large discrepancies in κ have been identified for the peak-compression conditions in ICF. To cover the wide range of density-temperature conditions undergone by ICF imploding fuel shells, we have performed QMD calculations of κ for a variety of deuterium densities of ρ = 1.0 to 673.518 g/cm3, at temperatures varying from T = 5 × 103 K to T = 8 × 106 K. The resulting κQMD of deuterium is fitted with a polynomial function of the coupling and degeneracy parameters Γ and θ, which can then be used in hydrodynamic simulation codes. Compared with the "hybrid" Spitzer-Lee-More model currently adopted in our hydrocode lilac, the hydrosimulations using the fitted κQMD have shown up to ˜20% variations in predicting target performance for different ICF implosions on OMEGA and direct-drive-ignition designs for the National Ignition Facility (NIF). The lower the adiabat of an imploding shell, the more variations in predicting target performance using κQMD. Moreover, the use of κQMD also modifies the shock conditions and the density-temperature profiles of the imploding shell at early implosion stage, which predominantly affects the final target performance. This is in contrast to the previous speculation that κQMD changes mainly the inside ablation process during the hot-spot formation of an ICF implosion.

  9. Functioning and Disability Analysis of Patients with Traumatic Brain Injury and Spinal Cord Injury by Using the World Health Organization Disability Assessment Schedule 2.0

    PubMed Central

    Kuo, Chia-Ying; Liou, Tsan-Hon; Chang, Kwang-Hwa; Chi, Wen-Chou; Escorpizo, Reuben; Yen, Chia-Feng; Liao, Hua-Fang; Chiou, Hung-Yi; Chiu, Wen-Ta; Tsai, Jo-Ting

    2015-01-01

    The purpose of this study is to compare traumatic brain injuries (TBI) and spinal cord injuries (SCI) patients’ function and disability by using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0); and to clarify the factors that contribute to disability. We analyzed data available between September 2012 and August 2013 from Taiwan’s national disability registry which is based on the International Classification of Functioning, Disability, and Health (ICF) framework. Of the 2664 cases selected for the study, 1316 pertained to TBI and 1348 to SCI. A larger percentage of patients with TBI compared with those with SCI exhibited poor cognition, self-care, relationships, life activities, and participation in society (all p < 0.001). Age, sex, injury type, socioeconomic status, place of residence, and severity of impairment were determined as factors that independently contribute to disability (all p < 0.05). The WHODAS 2.0 is a generic assessment instrument which is appropriate for assessing the complex and multifaceted disability associated with TBI and SCI. Further studies are needed to validate the WHODAS 2.0 for TBI and SCI from a multidisciplinary perspective. PMID:25874682

  10. Management of paediatric tibial fractures using two types of circular external fixator: Taylor spatial frame and Ilizarov circular fixator.

    PubMed

    Tafazal, Suhayl; Madan, Sanjeev S; Ali, Farhan; Padman, Manoj; Swift, Simone; Jones, Stanley; Fernandes, James A

    2014-05-01

    The use of circular fixators for the treatment of tibial fractures is well established in the literature. The aim of this study was to compare the Ilizarov circular fixator (ICF) with the Taylor spatial frame (TSF) in terms of treatment results in consecutive patients with tibial fractures that required operative management. A retrospective analysis of patient records and radiographs was performed to obtain patient data, information on injury sustained, the operative technique used, time duration in frame, healing time and complications of treatment. The minimum follow-up was 24 months. Ten patients were treated with ICF between 2000 and 2005, while 15 patients have been treated with TSF since 2005. Two of the 10 treated with ICF and 5 of the 15 treated with TSF were open fractures. All patients went on to achieve complete union. Mean duration in the frame was 12.7 weeks for ICF and 14.8 weeks for the TSF group. Two patients in the TSF group had delayed union and required additional procedures including adjustment of fixator and bone grafting. There was one malunion in the TSF group that required osteotomy and reapplication of frame. There were seven and nine pin-site infections in the ICF and TSF groups, respectively, all of which responded to antibiotics. There were no refractures in either group. In an appropriate patient, both types of circular fixator are equally effective but have different characteristics, with TSF allowing for postoperative deformity correction. Of concern are the two cases of delayed union in the TSF group, all in patients with high-energy injuries. We feel another larger study is required to provide further clarity in this matter. Level II-comparative study.

  11. Factors influencing work participation of adults with developmental dyslexia: a systematic review

    PubMed Central

    2014-01-01

    Background Evidence has been synthesized to determine hindering and facilitating factors associated with the work participation of adults with developmental dyslexia (DD), classified according to the International Classification of Functioning, Disability and Health (ICF). Methods A systematic literature review has been performed. Two search strings were used to determine the population and the context of work. The ICF was expanded with two subdivisions: one that made the environmental factors more work-related and a subdivision of personal factors. For data extraction the method known as qualitative metasummary was used and the manifest frequency effect size (MFES) for each category in the ICF was calculated. Results From 33 included studies 318 factors have been extracted and classified in the ICF. In the classification the frequency of occurrences and the consistency in direction (i.e., hindering or facilitating) have been made visible. The ICF categories with the highest MFES were mental functions with factors like feelings and emotions about dyslexia; activities like reading or writing/spelling; participation with factors like acquiring and keeping a job; social relationships at work where the attitudes and support of the employer and co-workers are important; working conditions with factors like the availability of assistive technology and accommodations on the job; and personal factors like self-disclosure and coping strategies. Conclusions In the context of work DD affects nearly all domains of functioning, mostly in a negative way. Within each domain the impact of DD increases over the course of life. To overcome that negative influence, many forms of adaptation, compensation, or coping are mentioned. Also notable is the lack of positive attitudes toward DD of the participants with DD—with the exception of the attitudes of teachers with DD—as well as on the part of colleagues, supervisors, and employers. PMID:24460949

  12. Moderators, mediators, and bidirectional relationships in the International Classification of Functioning, Disability and Health (ICF) framework: An empirical investigation using a longitudinal design and Structural Equation Modeling (SEM).

    PubMed

    Rouquette, Alexandra; Badley, Elizabeth M; Falissard, Bruno; Dub, Timothée; Leplege, Alain; Coste, Joël

    2015-06-01

    The International Classification of Functioning, Disability and Health (ICF) published in 2001 describes the consequences of health conditions with three components of impairments in body structures or functions, activity limitations and participation restrictions. Two of the new features of the conceptual model were the possibility of feedback effects between each ICF component and the introduction of contextual factors conceptualized as moderators of the relationship between the components. The aim of this longitudinal study is to provide empirical evidence of these two kinds of effect. Structural equation modeling was used to analyze data from a French population-based cohort of 548 patients with knee osteoarthritis recruited between April 2007 and March 2009 and followed for three years. Indicators of the body structure and function, activity and participation components of the ICF were derived from self-administered standardized instruments. The measurement model revealed four separate factors for body structures impairments, body functions impairments, activity limitations and participation restrictions. The classic sequence from body impairments to participation restrictions through activity limitations was found at each assessment time. Longitudinal study of the ICF component relationships showed a feedback pathway indicating that the level of participation restrictions at baseline was predictive of activity limitations three years later. Finally, the moderating role of personal (age, sex, mental health, etc.) and environmental factors (family relationships, mobility device use, etc.) was investigated. Three contextual factors (sex, family relationships and walking stick use) were found to be moderators for the relationship between the body impairments and the activity limitations components. Mental health was found to be a mediating factor of the effect of activity limitations on participation restrictions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. The proceedings of the 1st international workshop on laboratory astrophysics experiments with large lasers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Remington, B.A.; Goldstein, W.H.

    1996-08-09

    The world has stood witness to the development of a number of highly sophisticated and flexible, high power laser facilities (energies up to 50 kJ and powers up to 50 TW), driven largely by the world-wide effort in inertial confinement fusion (ICF). The charter of diagnosing implosions with detailed, quantitative measurements has driven the ICF laser facilities to be exceedingly versatile and well equipped with diagnostics. Interestingly, there is considerable overlap in the physics of ICF and astrophysics. Both typically involve compressible radiative hydrodynamics, radiation transport, complex opacities, and equations of state of dense matter. Surprisingly, however, there has beenmore » little communication between these two communities to date. With the recent declassification of ICF in the USA, and the approval to commence with construction of the next generation ``superlasers``, the 2 MJ National Ignition Facility in the US, and its equivalent, the LMJ laser in France, the situation is ripe for change. . Given the physics similarities that exist between ICF and astrophysics, one strongly suspects that there should exist regions of overlap where supporting research on the large lasers could be beneficial to the astrophysics community. As a catalyst for discussions to this end, Lawrence Livermore National Laboratory sponsored this workshop. Approximately 100 scientists attended from around the world, representing eight countries: the USA, Canada, UK, France, Germany, Russia, Japan, and Israel. A total of 30 technical papers were presented. The two day workshop was divided into four sessions, focusing on nonlinear hydrodynamics, radiative hydrodynamics, radiation transport, and atomic physics-opacities. Copies of the presentations are contained in these proceedings.« less

  14. Using the ICF to develop the capability-oriented database of persons with disabilities: a case study in Nakornpanom province, Thailand.

    PubMed

    Tongsiri, Sirinart; Riewpaiboon, Wachara

    2013-06-01

    This study aims to determine functioning information, rehabilitation needs, and environmental barriers of persons with disabilities (PWDs) using a developed ICF-based questionnaire with community survey approach in Thailand. A systematic review of the use of ICF and disability surveys from January 2000- June 2010 was undertaken. A questionnaire was then developed and tested in two pilot studies before using in a face-to-face interview conducted with legally registered PWDs in Nakornpanom province. Forty-six ICF codes were used in the questionnaire; two second-level codes in body functions, 18 second-level and six third-level codes in activities & participation and 14 second-level and six third-level codes in environmental factors. Each code had 2-6 qualifiers. One thousand and seven PWDs (56.6% male, mean age = 48.4 ± 0.64 years) were interviewed by 16 trained-interviewers. Interview duration was approximately 17 min. The functioning profile could be revealed for both individual and population. These reflected the need for rehabilitation. Several cut-off points to identify "disabled persons" were offered. Regarding participation, PWDs were concerned more about environmental barriers. One-fourth of PWDs needed home environment adaptation, almost 13% were uneducated and 23% had limited chance to participate in social activities. ICF framework and codes can be used to develop a questionnaire to measure population functioning profile and rehabilitation needs of PWDs by community survey. Results can be used to develop a capability-oriented disability database to identify prevalence of disabilities and rehabilitation needs. Policy makers may use this database to plan, monitor and evaluate rehabilitation service programs and removal of environmental barriers.

  15. Research ethics board approval for an international thromboprophylaxis trial.

    PubMed

    Lutz, Kristina; Wilton, Kelly; Zytaruk, Nicole; Julien, Lisa; Hall, Richard; Harvey, Johanne; Skrobik, Yoanna; Vlahakis, Nicholas; Meade, Laurie; Matte, Andrea; Meade, Maureen; Burns, Karen; Albert, Martin; Cash, Bronwyn Barlow; Vallance, Shirley; Klinger, James; Heels-Ansdell, Diane; Cook, Deborah

    2012-06-01

    Research ethics board (REB) review of scientific protocols is essential, ensuring participants' dignity, safety, and rights. The objectives of this study were to examine the time from submission to approval, to analyze predictors of approval time, and to describe the scope of conditions from REBs evaluating an international thromboprophylaxis trial. We generated survey items through literature review and investigators' discussions, creating 4 domains: respondent and institutional demographics, the REB application process, and alternate consent models. We conducted a document analysis that involved duplicate assessment of themes from REB critique of the protocol and informed consent forms (ICF). Approval was granted from 65 REB institutions, requiring 58 unique applications. We analyzed 44 (75.9%) of 58 documents and surveys. Survey respondents completing the applications had 8 (5-12) years of experience; 77% completed 4 or more REB applications in previous 5 years. Critical care personnel were represented on 54% of REBs. The time to approval was a median (interquartile range) of 75 (42, 150) days, taking longer for sites with national research consortium membership (89.1 vs 31.0 days, P = .03). Document analysis of the application process and ICF yielded 5 themes: methodology, data management, consent procedures, cataloguing, and miscellaneous. Protocol-specific themes focused on trial implementation, external critiques, and budget. The only theme specific to the ICF was risks and benefits. The most frequent comments on the protocol and ICF were about methodology and miscellaneous issues; ICF comments also addressed study risks and benefits. More studies on methods to enhance efficiency and consistency of the REB approval processes for clinical trials are needed while still maintaining high ethical standards. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Targeted radionuclide therapy of melanoma: anti-tumoural efficacy studies of a new 131I labelled potential agent.

    PubMed

    Bonnet-Duquennoy, Mathilde; Papon, Janine; Mishellany, Florence; Labarre, Pierre; Guerquin-Kern, Jean-Luc; Wu, Ting-Di; Gardette, Maryline; Maublant, Jean; Penault-Llorca, Frédérique; Miot-Noirault, Elisabeth; Cayre, Anne; Madelmont, Jean-Claude; Chezal, Jean-Michel; Moins, Nicole

    2009-08-01

    In recent years, there has been dramatic worldwide increase in incidence of malignant melanoma. Although localised disease is often curable by surgical excision, metastatic melanoma is inherently resistant to most treatments. In this context, targeted radionuclide therapy could be an efficient alternative. After pharmacomodulation study, we selected a quinoxaline derivative molecule (ICF01012) for its high, specific and long-lasting uptake in melanoma with rapid clearance from nontarget organs providing suitable dosimetry parameters for targeted radiotherapy. Aim of this study was to investigate, in vivo, efficacy of [(131)I]ICF01012 on nonmetastatic B16F0, metastatic B16Bl6 or human M4Beu melanoma tumours. First, colocalisation of ICF01012 with melanin by SIMS imaging was observed. Second, we showed that treatment drastically inhibited growth of B16F0, B16Bl6 and M4beu tumours whereas [(131)I]NaI or unlabelled ICF01012 treatment was without significant effect. Histological analysis and measure of PCNA proliferation marker expression showed that residual B16 tumour cells exhibit a significant loss of aggressiveness after treatment. This effect is associated with a lengthening of the treated-mice survival time. Moreover, with B16Bl6 model, 55% of the untreated mice had lung metastases whereas no metastasis was counted on treated group. Our data demonstrated a strong anti-tumoural effect of [(131)I]ICF01012 for radionuclide therapy on murine and human in vivo pigmented melanoma models, whatever their dissemination profiles and their melanin content be. Further studies will attempt to optimise therapy protocol by increasing the balance between the anti-tumoural effect and the safety on non-target organs.

  17. Mobile assessment of the lower limb kinematics in healthy persons and in persons with degenerative knee disorders: A systematic review.

    PubMed

    van der Straaten, R; De Baets, L; Jonkers, I; Timmermans, A

    2018-01-01

    Inertial sensor systems are increasingly used in the assessment of persons with knee osteoarthritis (KOA) and total knee replacement (TKR). This systematic review aims to (1) investigate the application of inertial sensor systems and kinematics derived from these systems, and (2) assess if current assessment protocols consist of tasks which are, according to the International Classification of Functioning, Disability and Health (ICF) for KOA, relevant for persons with KOA and TKR. A search was conducted in six electronic databases (ACM, CINAHL, EMBASE, IEEE, PubMed, Web of Science) to include papers assessing the knee and one or more adjacent joints by means of inertial sensors in healthy persons or persons with KOA or TKR. Two reviewers checked the methodological quality. Twenty-three papers were included: 18 in healthy persons and five in persons with KOA or TKR. In healthy persons, 11 tasks were related to metrics of the ICF-function and ICF-activity level. In persons with KOA, only walking was assessed. Apart from walking, four additional tasks were related to the ICF-function and ICF-activity level in persons with TKR. In healthy persons, joints located proximally and distally to the knee were assessed, while in persons with KOA and TKR, only the knee and ankle were assessed. This is a shortcoming since hip and trunk motion potentially contain clinically relevant information, in terms of identifying (mal)adaptive compensatory movement strategies. Additionally, physically more demanding tasks should be evaluated as these might be superior in detecting compensatory movement strategies. Former considerations warrant attention in future research. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Factors influencing work participation of adults with developmental dyslexia: a systematic review.

    PubMed

    de Beer, Joost; Engels, Josephine; Heerkens, Yvonne; van der Klink, Jac

    2014-01-24

    Evidence has been synthesized to determine hindering and facilitating factors associated with the work participation of adults with developmental dyslexia (DD), classified according to the International Classification of Functioning, Disability and Health (ICF). A systematic literature review has been performed. Two search strings were used to determine the population and the context of work. The ICF was expanded with two subdivisions: one that made the environmental factors more work-related and a subdivision of personal factors. For data extraction the method known as qualitative metasummary was used and the manifest frequency effect size (MFES) for each category in the ICF was calculated. From 33 included studies 318 factors have been extracted and classified in the ICF. In the classification the frequency of occurrences and the consistency in direction (i.e., hindering or facilitating) have been made visible. The ICF categories with the highest MFES were mental functions with factors like feelings and emotions about dyslexia; activities like reading or writing/spelling; participation with factors like acquiring and keeping a job; social relationships at work where the attitudes and support of the employer and co-workers are important; working conditions with factors like the availability of assistive technology and accommodations on the job; and personal factors like self-disclosure and coping strategies. In the context of work DD affects nearly all domains of functioning, mostly in a negative way. Within each domain the impact of DD increases over the course of life. To overcome that negative influence, many forms of adaptation, compensation, or coping are mentioned. Also notable is the lack of positive attitudes toward DD of the participants with DD-with the exception of the attitudes of teachers with DD-as well as on the part of colleagues, supervisors, and employers.

  19. Quality of life in older individuals with joint contractures in geriatric care settings.

    PubMed

    Heise, Marco; Müller, Martin; Fischer, Uli; Grill, Eva

    2016-09-01

    The purpose of this study was to analyze the association between functioning and disability and quality of life (QoL) in older individuals with joint contractures in the geriatric care setting. More specifically, this study aimed to identify determinants of QoL out of a defined set of contracture-related categories of the International Classification of Functioning, Disability and Health (ICF). Participants for this multicenter cross-sectional survey were recruited from acute geriatric rehabilitation hospitals, nursing homes, and community nursing facilities in Germany between February and October 2013. QoL was assessed using the validated German version of the EQ-5D index score and the EQ-5D visual analog scale (VAS). Manual and automatic variable selection methods were used to identify the most relevant variables out of 125 contracture-related ICF categories. A total of 241 eligible participants (34.9 % male, mean age 80.1 years) were included. The final models contained 14 ICF categories as predictors of the EQ-5D index score and 15 categories as predictors of the EQ-5D VAS. The statistically significant ICF categories from both models were 'muscle power functions (b730),' 'memory functions (b144),' 'taking care of plants (d6505),' 'recreation and leisure (d920),' 'religion and spirituality (d930),' 'drugs (e1101),' and 'products and technology for personal use in daily living (e115).' We identified the most relevant ICF categories for older individuals with joint contractures and their health-related quality of life. These items describe potential determinants of QoL which may provide the basis for future health interventions aiming to improve QoL for the patients with joint contractures.

  20. Satisfaction and sense of well being among Medicaid ICF/MR and HCBS recipients in six states.

    PubMed

    Stancliffe, Roger J; Lakin, K Charlie; Taub, Sarah; Chiri, Giuseppina; Byun, Soo-Yong

    2009-04-01

    Self-reported satisfaction and sense of well-being were assessed in a sample of 1,885 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services in 6 states. Questions dealt with such topics as loneliness, feeling afraid at home and in one's neighborhood, feeling happy, feeling that staff are nice and polite, and liking one's home and work/day program. Loneliness was the most widespread problem, and there were also small percentages of people who reported negative views in other areas. Few differences were evident by HCBS and ICF/MR status. The findings document consistent benefits of residential support provided in very small settings-with choices of where and with whom to live-and to individuals living with family.

  1. The content of goals in individual educational programs for students with complex communication needs.

    PubMed

    Klang, Nina; Rowland, Charity; Fried-Oken, Melanie; Steiner, Sandra; Granlund, Mats; Adolfsson, Margareta

    2016-01-01

    The aim of the study was to explore the contents of communication-related goals in individualized education programs (IEPs) for students with complex communication needs. Goals in 43 IEPs were linked to the International Classification of Functioning, Disability and Health, Children and Youth version (ICF-CY). The results show that the communication-related IEP goals contain information on multiple domains of functioning in the ICF-CY. However, judging by the amount of codes linked to ICF-CY chapters, the IEPs contain a relatively small proportion of goals that focus on interaction with others, or participation in classroom and leisure activities. Special education teachers and speech-language pathologists working with students with complex communication needs may need support to formulate communication-related IEP goals with a focus on interaction and participation in school activities.

  2. Applying Failure Modes, Effects, And Criticality Analysis And Human Reliability Analysis Techniques To Improve Safety Design Of Work Process In Singapore Armed Forces

    DTIC Science & Technology

    2016-09-01

    an instituted safety program that utilizes a generic risk assessment method involving the 5-M (Mission, Man, Machine , Medium and Management) factor...the Safety core value is hinged upon three key principles—(1) each soldier has a crucial part to play, by adopting safety as a core value and making...it a way of life in his unit; (2) safety is an integral part of training, operations and mission success, and (3) safety is an individual, team and

  3. News on Seeking Gaia's Astrometric Core Solution with AGIS

    NASA Astrophysics Data System (ADS)

    Lammers, U.; Lindegren, L.

    We report on recent new developments around the Astrometric Global Iterative Solution system. This includes the availability of an efficient Conjugate Gradient solver and the Generic Astrometric Calibration scheme that had been proposed a while ago. The number of primary stars to be included in the core solution is now believed to be significantly higher than the 100 Million that served as baseline until now. Cloud computing services are being studied as a possible cost-effective alternative to running AGIS on dedicated computing hardware at ESAC during the operational phase.

  4. European validation of The Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis from the perspective of patients with osteoarthritis of the knee or hip.

    PubMed

    Weigl, Martin; Wild, Heike

    2017-09-15

    To validate the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis from the patient perspective in Europe. This multicenter cross-sectional study involved 375 patients with knee or hip osteoarthritis. Trained health professionals completed the Comprehensive Core Set, and patients completed the Short-Form 36 questionnaire. Content validity was evaluated by calculating prevalences of impairments in body function and structures, limitations in activities and participation and environmental factors, which were either barriers or facilitators. Convergent construct validity was evaluated by correlating the International Classification of Functioning, Disability and Health categories with the Short-Form 36 Physical Component Score and the SF-36 Mental Component Score in a subgroup of 259 patients. The prevalences of all body function, body structure and activities and participation categories were >40%, >32% and >20%, respectively, and all environmental factors were relevant for >16% of patients. Few categories showed relevant differences between knee and hip osteoarthritis. All body function categories and all but two activities and participation categories showed significant correlations with the Physical Component Score. Body functions from the ICF chapter Mental Functions showed higher correlations with the Mental Component Score than with the Physical Component Score. This study supports the validity of the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis. Implications for Rehabilitation Comprehensive International Classification of Functioning, Disability and Health Core Sets were developed as practical tools for application in multidisciplinary assessments. The validity of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis in this study supports its application in European patients with osteoarthritis. The differences in results between this Europe validation study and a previous Singaporean validation study underscore the need to validate the International Classification of Functioning, Disability and Health Core Sets in different regions of the world.

  5. Do generic utility measures capture what is important to the quality of life of people with multiple sclerosis?

    PubMed

    Kuspinar, Ayse; Mayo, Nancy E

    2013-04-25

    The three most widely used utility measures are the Health Utilities Index Mark 2 and 3 (HUI2 and HUI3), the EuroQol-5D (EQ-5D) and the Short-Form-6D (SF-6D). In line with guidelines for economic evaluation from agencies such as the National Institute for Health and Clinical Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health (CADTH), these measures are currently being used to evaluate the cost-effectiveness of different interventions in MS. However, the challenge of using such measures in people with a specific health condition, such as MS, is that they may not capture all of the domains that are impacted upon by the condition. If important domains are missing from the generic measures, the value derived will be higher than the real impact creating invalid comparisons across interventions and populations. Therefore, the objective of this study is to estimate the extent to which generic utility measures capture important domains that are affected by MS. The available study population consisted of men and women who had been registered after 1994 in three participating MS clinics in Greater Montreal, Quebec, Canada. Subjects were first interviewed on an individualized measure of quality of life (QOL) called the Patient Generated Index (PGI). The domains identified with the PGI were then classified and grouped together using the World Health Organization's International Classification of Functioning, Disability and Health (ICF), and mapped onto the HUI2, HUI3, EQ-5D and SF-6D. A total of 185 persons with MS were interviewed on the PGI. The sample was relatively young (mean age 43) and predominantly female. Both men and women had mild disability with a median Expanded Disability Status Scale (EDSS) score of 2. The top 10 domains that patients identified to be the most affected by their MS were, work (62%), fatigue (48%), sports (39%), social life (28%), relationships (23%), walking/mobility (22%), cognition (21%), balance (14%), housework (12%) and mood (11%). The SF-6D included the most number of domains (6 domains) important to people with MS, followed by the EQ-5D (4 domains) and the HUI2 (4 domains) and then the HUI3 (3 domains). The mean and standard deviation (SD) for the PGI, EQ-5D and the SF-6D were 0.50 (SD 0.25), 0.69 (0.18) and 0.69 (0.13), respectively. The magnitude of difference between the PGI and the generic utility measures was large and statistically significant. Although the generic utility measures included certain items that were important to people with MS, there were several that were missing. An important consequence of this mismatch was that values of QOL derived from the PGI were importantly and significantly lower than those estimated using any of the generic utility measures. This could have a substantial impact in evaluating the effect of interventions for people with MS.

  6. Do generic utility measures capture what is important to the quality of life of people with multiple sclerosis?

    PubMed Central

    2013-01-01

    Purpose The three most widely used utility measures are the Health Utilities Index Mark 2 and 3 (HUI2 and HUI3), the EuroQol-5D (EQ-5D) and the Short-Form-6D (SF-6D). In line with guidelines for economic evaluation from agencies such as the National Institute for Health and Clinical Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health (CADTH), these measures are currently being used to evaluate the cost-effectiveness of different interventions in MS. However, the challenge of using such measures in people with a specific health condition, such as MS, is that they may not capture all of the domains that are impacted upon by the condition. If important domains are missing from the generic measures, the value derived will be higher than the real impact creating invalid comparisons across interventions and populations. Therefore, the objective of this study is to estimate the extent to which generic utility measures capture important domains that are affected by MS. Methods The available study population consisted of men and women who had been registered after 1994 in three participating MS clinics in Greater Montreal, Quebec, Canada. Subjects were first interviewed on an individualized measure of quality of life (QOL) called the Patient Generated Index (PGI). The domains identified with the PGI were then classified and grouped together using the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), and mapped onto the HUI2, HUI3, EQ-5D and SF-6D. Results A total of 185 persons with MS were interviewed on the PGI. The sample was relatively young (mean age 43) and predominantly female. Both men and women had mild disability with a median Expanded Disability Status Scale (EDSS) score of 2. The top 10 domains that patients identified to be the most affected by their MS were, work (62%), fatigue (48%), sports (39%), social life (28%), relationships (23%), walking/mobility (22%), cognition (21%), balance (14%), housework (12%) and mood (11%). The SF-6D included the most number of domains (6 domains) important to people with MS, followed by the EQ-5D (4 domains) and the HUI2 (4 domains) and then the HUI3 (3 domains). The mean and standard deviation (SD) for the PGI, EQ-5D and the SF-6D were 0.50 (SD 0.25), 0.69 (0.18) and 0.69 (0.13), respectively. The magnitude of difference between the PGI and the generic utility measures was large and statistically significant. Conclusion Although the generic utility measures included certain items that were important to people with MS, there were several that were missing. An important consequence of this mismatch was that values of QOL derived from the PGI were importantly and significantly lower than those estimated using any of the generic utility measures. This could have a substantial impact in evaluating the effect of interventions for people with MS. PMID:23618072

  7. Electronic Structure Calculations and Adaptation Scheme in Multi-core Computing Environments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Seshagiri, Lakshminarasimhan; Sosonkina, Masha; Zhang, Zhao

    2009-05-20

    Multi-core processing environments have become the norm in the generic computing environment and are being considered for adding an extra dimension to the execution of any application. The T2 Niagara processor is a very unique environment where it consists of eight cores having a capability of running eight threads simultaneously in each of the cores. Applications like General Atomic and Molecular Electronic Structure (GAMESS), used for ab-initio molecular quantum chemistry calculations, can be good indicators of the performance of such machines and would be a guideline for both hardware designers and application programmers. In this paper we try to benchmarkmore » the GAMESS performance on a T2 Niagara processor for a couple of molecules. We also show the suitability of using a middleware based adaptation algorithm on GAMESS on such a multi-core environment.« less

  8. Factors Associated with Expenditures for Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) Services for Persons with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Lakin, K. Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger J.; Taub, Sarah; Chiri, Giuseppina

    2008-01-01

    This article examines expenditures for a random sample of 1,421 adult Home and Community Based Services (HCBS) and Intermediate Care Facility/Mental Retardation (ICF/MR) recipients in 4 states. The article documents variations in expenditures for individuals with different characteristics and service needs and, controlling for individual…

  9. The Use of the International Classification of Functioning, Disability and Health, Version for Children and Youth (ICF-CY), in Portuguese Special Education Assessment and Eligibility Procedures: The Professionals' Perceptions

    ERIC Educational Resources Information Center

    Sanches-Ferreira, Manuela; Silveira-Maia, Mónica; Alves, Sílvia

    2014-01-01

    Portugal was the first country decreeing the mandatory use of the International Classification of Functioning, Disability and Health: Child and Youth (ICF-CY) framework for guiding special education assessment process and to base eligibility decision-making on students' functioning profiles--in contrast with traditional approaches centred on…

  10. DOE Office of Scientific and Technical Information (OSTI.GOV)

    none,

    This case study describes a DOE Zero Energy Ready Home in Old Greenwich, CT, that scored HERS 40 without PV and HERS 27 with PV. This 4,100 ft2 custom home has 13-inch ICF basement walls and 11-inch ICF above-grade walls with a closed-cell spray foam-insulated roof deck, and a continuously running ERV. The house has a dual-fuel heat pump, an instantaneous condensing water heater, and 4.5-kW solar shingles.

  11. Nova Upgrade: A proposed ICF facility to demonstrate ignition and gain, revision 1

    NASA Astrophysics Data System (ADS)

    1992-07-01

    The present objective of the national Inertial Confinement Fusion (ICF) Program is to determine the scientific feasibility of compressing and heating a small mass of mixed deuterium and tritium (DT) to conditions at which fusion occurs and significant energy is released. The potential applications of ICF will be determined by the resulting fusion energy yield (amount of energy produced) and gain (ratio of energy released to energy required to heat and compress the DT fuel). Important defense and civilian applications, including weapons physics, weapons effects simulation, and ultimately the generation of electric power will become possible if yields of 100 to 1,000 MJ and gains exceeding approximately 50 can be achieved. Once ignition and propagating bum producing modest gain (2 to 10) at moderate drive energy (1 to 2 MJ) has been achieved, the extension to high gain (greater than 50) is straightforward. Therefore, the demonstration of ignition and modest gain is the final step in establishing the scientific feasibility of ICF. Lawrence Livermore National Laboratory (LLNL) proposes the Nova Upgrade Facility to achieve this demonstration by the end of the decade. This facility would be constructed within the existing Nova building at LLNL for a total cost of approximately $400 M over the proposed FY 1995-1999 construction period. This report discusses this facility.

  12. Comparison of high-density carbon implosions in unlined uranium versus gold hohlraums

    NASA Astrophysics Data System (ADS)

    Dewald, Eduard; Meezan, Nathan; Tommasini, Riccardo; Khan, Shahab; MacKinnon, Andrew; Berzak Hopkins, Laura; Divol, Laurent; Lepape, Sebastien; Moore, Alastair; Schneider, Marilyn; Pak, Arthur; Nikroo, Abbas; Landen, Otto

    2016-10-01

    In Inertial Confinement Fusion (ICF) implosions, laser energy is converted to x-ray radiation in hohlraums with High-Z walls. At radiation temperatures near 300 eV relevant for ICF experiments, the radiative losses in heating the wall are lower for U than for Au hohlraums. Furthermore, the intensity of the ``M-band'' x-rays with photon energies h ν >1.8 keV is lower for uranium, allowing for reduced capsule dopant concentrations employed to minimize inner ablator preheat and hence keep favorable fuel/ablator interface Atwood numbers. This in turn improves the ablator rocket efficiency and reduces the risk of polluting the hot-spot with emissive dopant material. The first uranium vacuum hohlraum experiments on the National Ignition Facility (NIF) with undoped high-density carbon (HDC, or diamond) capsules have demonstrated 30% lower ``M-band'' intensity relative to Au, resulting in lower inflight ablator thickness due to reduced preheat. In addition, fusion neutron yields are 2x higher in U than in Au hohlraums for D2-gas filled capsule implosions at ICF relevant velocities of 380 +/-20 km/s. These results have led the NIF ICF implosions to routinely employ U hohlraums. Prepared by LLNL under Contract DE-AC52-07NA27344.

  13. Individual interviews and focus groups in patients with rheumatoid arthritis: a comparison of two qualitative methods.

    PubMed

    Coenen, Michaela; Stamm, Tanja A; Stucki, Gerold; Cieza, Alarcos

    2012-03-01

    To compare two different approaches to performing focus groups and individual interviews, an open approach, and an approach based on the International Classification of Functioning, Disability and Health (ICF). Patients with rheumatoid arthritis attended focus groups (n = 49) and individual interviews (n = 21). Time, number of concepts, ICF categories identified, and sample size for reaching saturation of data were compared. Descriptive statistics, Chi-square tests, and independent t tests were performed. With an overall time of 183 h, focus groups were more time consuming than individual interviews (t = 9.782; P < 0.001). In the open approach, 188 categories in the focus groups and 102 categories in the interviews were identified compared to the 231 and 110 respective categories identified in the ICF-based approach. Saturation of data was reached after performing five focus groups and nine individual interviews in the open approach and five focus groups and 12 individual interviews in the ICF-based approach. The method chosen should depend on the objective of the study, issues related to the health condition, and the study's participants. We recommend performing focus groups if the objective of the study is to comprehensively explore the patient perspective.

  14. When shape matters: Correcting the ICFs to derive the chemical abundances of bipolar and elliptical PNe

    NASA Astrophysics Data System (ADS)

    Gonçalves, Denise R.; Wesson, Roger; Morisset, Cristophe; Barlow, Michael; Ercolano, Barbara

    2012-08-01

    The extraction of chemical abundances of ionised nebulae from a limited spectral range is usually hampered by the lack of emission lines corresponding to certain ionic stages. So far, the missing emission lines have been accounted for by the ionisation correction factors (ICFs), constructed under simplistic assumptions like spherical geometry by using 1-D photoionisation modelling. In this contribution we discuss the results (Gonçalves et al. 2011, in prep.) of our ongoing project to find a new set of ICFs to determine total abundances of N, O, Ne, Ar, and S, with optical spectra, in the case of non-spherical PNe. These results are based on a grid of 3-D photoionisation modelling of round, elliptical and bipolar shaped PNe, spanning the typical PN luminosities, effective temperatures and densities. We show that the additional corrections to the widely used Kingsburgh & Barlow (1994) ICFs are always higher for bipolars than for ellipticals. Moreover, these additional corrections are, for bipolars, up to: 17% for oxygen, 33% for nitrogen, 40% for neon, 28% for argon and 50% for sulphur. Finally, on top of the fact that corrections change greatly with shape, they vary also greatly with the central star temperature, while the luminosity is a less important parameter.

  15. Beneficial effects of a medicinal herb, Cirsium japonicum var. maackii, extract and its major component, cirsimaritin on breast cancer metastasis in MDA-MB-231 breast cancer cells.

    PubMed

    Yeon Park, Jun; Young Kim, Hyun; Shibamoto, Takayuki; Su Jang, Tae; Cheon Lee, Sang; Suk Shim, Jae; Hahm, Dae-Hyun; Lee, Hae-Jeung; Lee, Sanghyun; Sung Kang, Ki

    2017-09-01

    The biological activities of the ethanol extract from Cirsium japonicum var. maackii (ICF-1) and its major component, polyphenol cirsimaritin, were investigated as part of the search for possible alternative drugs for breast cancer. Three in vitro cell-based assays were used: the cell proliferation assay, tube-formation assay, and Western blot analysis. Both the ICF-1 extract and cirsimaritin inhibited the viability of HUVECs in a dose-dependent manner. The inhibition achieved was 36.89% at a level of 200μg/ml by the ICF-1 extract and 62.04% at a level of 100μM by cirsimaritin. The ICF-1 extract and cirsimaritin reduced tube formation by 12.69% at level of 25μg/ml and 32.18% at the levels of 6.25μM, respectively. Cirsimaritin inhibited angiogenesis by downregulation of VEGF, p-Akt and p-ERK in MDA-MB-231 cells, suggesting that cirsimaritin is potentially useful as an anti-metastatic agent. The present study demonstrated that Cirsium japonicum extract and its active component cirsimaritin is an excellent candidate as an alternative anti-breast cancer drug. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Dose heterogeneity correction for low-energy brachytherapy sources using dual-energy CT images

    NASA Astrophysics Data System (ADS)

    Mashouf, S.; Lechtman, E.; Lai, P.; Keller, B. M.; Karotki, A.; Beachey, D. J.; Pignol, J. P.

    2014-09-01

    Permanent seed implant brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose around brachytherapy sources is based on the AAPM TG-43 formalism, which generates the dose in a homogeneous water medium. Recently, AAPM TG-186 emphasized the importance of accounting for tissue heterogeneities. We have previously reported on a methodology where the absorbed dose in tissue can be obtained by multiplying the dose, calculated by the TG-43 formalism, by an inhomogeneity correction factor (ICF). In this work we make use of dual energy CT (DECT) images to extract ICF parameters. The advantage of DECT over conventional CT is that it eliminates the need for tissue segmentation as well as assignment of population based atomic compositions. DECT images of a heterogeneous phantom were acquired and the dose was calculated using both TG-43 and TG-43 × \\text{ICF} formalisms. The results were compared to experimental measurements using Gafchromic films in the mid-plane of the phantom. For a seed implant configuration of 8 seeds spaced 1.5 cm apart in a cubic structure, the gamma passing score for 2%/2 mm criteria improved from 40.8% to 90.5% when ICF was applied to TG-43 dose distributions.

  17. FY16 LLNL Omega Experimental Programs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Heeter, R. F.; Ali, S. J.; Benstead, J.

    In FY16, LLNL’s High-Energy-Density Physics (HED) and Indirect Drive Inertial Confinement Fusion (ICF-ID) programs conducted several campaigns on the OMEGA laser system and on the EP laser system, as well as campaigns that used the OMEGA and EP beams jointly. Overall, these LLNL programs led 430 target shots in FY16, with 304 shots using just the OMEGA laser system, and 126 shots using just the EP laser system. Approximately 21% of the total number of shots (77 OMEGA shots and 14 EP shots) supported the Indirect Drive Inertial Confinement Fusion Campaign (ICF-ID). The remaining 79% (227 OMEGA shots and 112more » EP shots) were dedicated to experiments for High-Energy-Density Physics (HED). Highlights of the various HED and ICF campaigns are summarized in the following reports. In addition to these experiments, LLNL Principal Investigators led a variety of Laboratory Basic Science campaigns using OMEGA and EP, including 81 target shots using just OMEGA and 42 shots using just EP. The highlights of these are also summarized, following the ICF and HED campaigns. Overall, LLNL PIs led a total of 553 shots at LLE in FY 2016. In addition, LLNL PIs also supported 57 NLUF shots on Omega and 31 NLUF shots on EP, in collaboration with the academic community.« less

  18. The PedsQL multidimensional fatigue scale in pediatric obesity: feasibility, reliability and validity.

    PubMed

    Varni, James W; Limbers, Christine A; Bryant, William P; Wilson, Don P

    2010-01-01

    The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health-related quality of life (HRQOL) and disease-specific symptoms in children and adolescents. The PedsQL Multidimensional Fatigue Scale was designed as a child self-report and parent proxy-report generic symptom-specific instrument to measure fatigue in pediatric patients. The objective of the present study was to determine the feasibility, reliability, and validity of the PedsQL Multidimensional Fatigue Scale in pediatric obesity. The 18-item PedsQL Multidimensional Fatigue Scale (General Fatigue, Sleep/Rest Fatigue, and Cognitive Fatigue domains) and the PedsQL 4.0 Generic Core Scales were completed by 41 pediatric patients with a physician-diagnosis of obesity and 43 parents from a hospital-based Pediatric Endocrinology Clinic. The PedsQL Multidimensional Fatigue Scale evidenced minimal missing responses (1.6%, child report; 0.5%, parent report), achieved excellent reliability for the Total Fatigue Scale Score (alpha = 0.90 child report, 0.90 parent report), distinguished between pediatric patients with obesity and healthy children, and was significantly correlated with the PedsQL 4.0 Generic Core Scales supporting construct validity. Pediatric patients with obesity experienced fatigue comparable with pediatric patients receiving cancer treatment, demonstrating the relative severity of their fatigue symptoms. The results demonstrate the measurement properties of the PedsQL Multidimensional Fatigue Scale in pediatric obesity. The findings suggest that the PedsQL Multidimensional Fatigue Scale may be utilized in the standardized evaluation of fatigue in pediatric patients with obesity.

  19. Linking Essential Learning Outcomes and Interprofessional Collaborative Practice Competency in Health Science Undergraduates

    ERIC Educational Resources Information Center

    Reed, Carole-Rae; Garcia, Luis Ivan; Slusser, Margaret M.; Konowitz, Sharon; Yep, Jewelry

    2017-01-01

    Assessing student learning outcomes and determining achievement of the Interprofessional Collaborative Practice (IPCEP) Core Competency of Values/Ethics in a generic pre-professional Bachelor of Science in Health Science (BSHS) program is challenging. A course level Student Learning Outcome (SLO) is: "….articulate the impact of personal…

  20. Work Force Education: Beyond Technical Skills. Trends and Issues Alert No. 1.

    ERIC Educational Resources Information Center

    Imel, Susan

    This brief suggests that during the past 2 decades, the skills needed to succeed in the workplace have changed significantly. Technical skills remain important, but, increasingly, employers recognize another category of skills crucial to a worker's ability to work "smarter, not harder." These "soft,""core,""nontechnical,""essential,""generic," and…

  1. Inference of the electron temperature in ICF implosions from the hard X-ray spectral continuum

    NASA Astrophysics Data System (ADS)

    Kagan, Grigory; Landen, O. L.; Svyatsky, D.; Sio, H.; Kabadi, N. V.; Simpson, R. A.; Gatu Johnson, M.; Frenje, J. A.; Petrasso, R. D.; Shah, R. C.; Joshi, T. R.; Hakel, P.; Weber, T. E.; Rinderknecht, H. G.; Thorn, D.; Schneider, M.; Bradley, D.; Kilkenny, J.

    2017-10-01

    The NIF Continuum Spectrometer, scheduled to be first deployed in Fall of 2017, will infer the imploded core electron temperature from the free-free continuum self-emission spectra of photons with energies of 20 to 30 keV. However, this hard X-ray radiation is emitted by the tail of the electron distribution, which likely deviates from Maxwellian and thus obscures interpretation of the data. We investigate resulting modifications to the X-ray spectra. The logarithmic slope of the spectrum from the more realistic, non-thermal tail of the electron distribution is found to decrease more rapidly at higher photon energies, as compared to the perfectly Maxwellian case. Interpreting the spectrum with assumption of Maxwellian electrons enforced is shown to give an electron temperature that is lower than the actual one. Conversely, due to its connection with the non-thermal features in the electron distribution, hard X-ray emission can provide unprecedented information about kinetic processes in the hot DT core. This work was performed under the auspices of the U.S. Dept. of Energy by the Los Alamos National Security, LLC, Los Alamos National Laboratory under Contract No. DE-AC52-06NA25396.

  2. Validation of modified forms of the PedsQL generic core scales and cancer module scales for adolescents and young adults (AYA) with cancer or a blood disorder.

    PubMed

    Ewing, Jane E; King, Madeleine T; Smith, Narelle F

    2009-03-01

    To validate two health-related quality of life (HRQOL) measures, the PedsQL Generic Core and Cancer Module adolescent forms (13-18 years), after modification for 16-25-year-old adolescents and young adults (AYA) with cancer or a blood disorder. AYA patients and nominated proxies were recruited from three Sydney hospitals. Modified forms were administered by telephone or in clinics/wards. Analyses included correlations, factor analysis, and analysis of variance of known-groups (defined by the Memorial Symptom Assessment Scale). Eighty-eight patients and 79 proxies completed questionnaires. Factor structures consistent with those of the unmodified forms confirmed construct validity. Cronbach's alpha ranged 0.81-0.98. Inter-scale correlations were as hypothesized, confirming discriminant validity. Statistically significant differences between groups with mild, moderate, and severe symptoms (P < 0.05) confirmed clinical validity. These modified forms provide reliable and valid measures of HRQOL in AYA with cancer or a blood disorder, suitable for clinical trials, research, and practice.

  3. Conceptual design of the National Ignition Facility

    NASA Astrophysics Data System (ADS)

    Paisner, Jeffrey A.; Boyes, John D.; Kumpan, Steven A.; Lowdermilk, W. Howard; Sorem, Michael S.

    1995-12-01

    The Secretary of the U.S. Department of Energy (DOE) commissioned a conceptual design report (CDR) for the National Ignition Facility (NIF) in January 1993 as part of a key decision zero (KD0), justification of mission need. Motivated by the progress to date by the inertial confinement fusion (ICF) program in meeting the Nova technical contract goals established by the National Academy of Sciences in 1989, the Secretary requested a design using a solid-state laser driver operating at the third harmonic (0.35 micrometer) of neodymium (Nd) glass. The participating ICF laboratories signed a memorandum of agreement in August 1993, and established a project organization, including a technical team from the Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Sandia National Laboratories (SNL), and the Laboratory for Laser Energetics at the University of Rochester. Since then, we completed the NIF conceptual design, based on standard construction at a generic DOE defense program's site, and issued a 7,000-page, 27-volume CDR in May 1994. Over the course of the conceptual design study, several other key documents were generated, including a facilities requirements document, a conceptual design scope and plan, a target physics design document, a laser design cost basis document, a functional requirements document, an experimental plan for indirect drive ignition, and a preliminary hazards analysis (PHA) document. DOE used the PHA to categorize the NIF as a low-hazard, non-nuclear facility. On October 21, 1994 the Secretary of Energy issued a key decision one (KD1) for the NIF, which approved the project and authorized DOE to request Office of Management and Budget-approval for congressional line-item FY 1996 NIF funding for preliminary engineering design and for National Environmental Policy Act activities. In addition, the Secretary declared Livermore as the preferred site for constructing the NIF. In February 1995, the NIF Project was formally submitted to Congress as part of the President's FY 1996 budget. If funded as planned, the Project will cost approximately $1.1 billion and will be completed at the end of FY 2002.

  4. Source Evaluation and Trace Metal Contamination in Benthic Sediments from Equatorial Ecosystems Using Multivariate Statistical Techniques

    PubMed Central

    Benson, Nsikak U.; Asuquo, Francis E.; Williams, Akan B.; Essien, Joseph P.; Ekong, Cyril I.; Akpabio, Otobong; Olajire, Abaas A.

    2016-01-01

    Trace metals (Cd, Cr, Cu, Ni and Pb) concentrations in benthic sediments were analyzed through multi-step fractionation scheme to assess the levels and sources of contamination in estuarine, riverine and freshwater ecosystems in Niger Delta (Nigeria). The degree of contamination was assessed using the individual contamination factors (ICF) and global contamination factor (GCF). Multivariate statistical approaches including principal component analysis (PCA), cluster analysis and correlation test were employed to evaluate the interrelationships and associated sources of contamination. The spatial distribution of metal concentrations followed the pattern Pb>Cu>Cr>Cd>Ni. Ecological risk index by ICF showed significant potential mobility and bioavailability for Cu, Cu and Ni. The ICF contamination trend in the benthic sediments at all studied sites was Cu>Cr>Ni>Cd>Pb. The principal component and agglomerative clustering analyses indicate that trace metals contamination in the ecosystems was influenced by multiple pollution sources. PMID:27257934

  5. Clinical decision making regarding intervention needs of infants with torticollis.

    PubMed

    Fradette, Julie; Gagnon, Isabelle; Kennedy, Eileen; Snider, Laurie; Majnemer, Annette

    2011-01-01

    Although conservative care is the standard intervention for infants with torticollis, the variation in intervention content and format proposed in the literature reflects the lack of clear understanding of this population's needs. The objective was to identify factors assessed by pediatricians and physical therapists influencing the determination of intervention needs for infants with torticollis. Focus groups and surveys were used to generate a list of factors influencing determination of intervention needs. These factors were mapped to the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY). Health care professionals report that all infants presenting with torticollis require intervention. They determine needs according to factors encompassing all ICF-CY domains. An important subset of factors relates to family and environment. Health care professionals should rely on a family-centered assessment encompassing all domains of the ICF-CY to adequately identify intervention needs of infants with torticollis.

  6. An empirical exploration of the relations between the health components of the International Classification of Functioning, Disability and Health (ICF).

    PubMed

    Perenboom, Rom J M; Wijlhuizen, Gert Jan; Garre, Francisca Galindo; Heerkens, Yvonne F; van Meeteren, Nico L U

    2012-01-01

    The aim of this study was to investigate the relations between the ICF components from a subjective perspective. Data on health condition and perceived functioning were collected among 2941 individuals with at least one chronic disease or disorder. Path analysis was used with perceived level of participation as the final denominator. Three models were tested: one with the number of chronic diseases and disorders as an indicator of health condition, one with perceived health as indicator of health condition, and one with perceived health as part of the personal factors. Although all models showed a good fit, the model with the best fit was that with perceived health as an indicator of health condition. From a patient's perspective, components of the ICF scheme appear to be associated with each other, with perceived health being the best indicator of the health condition.

  7. Inertial Confinement Fusion Quarterly Report: April--June 1993. Volume 3, Number 3

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MacGowan, B.J.; Kotowski, M.; Schleich, D.

    1993-11-01

    This issue of the ICF Quarterly contains six articles describing recent advances in Lawrence Livermore National Laboratory`s inertial confinement fusion (ICF) program. The current emphasis of the ICF program is in support of DOE`s National Ignition Facility (NIF) initiative for demonstrating ignition and gain with a 1-2 MJ glass laser. The articles describe recent Nova experiments and investigations tailored towards enhancing understanding of the key physics and technological issues for the NIF. Titles of the articles are: development of large-aperture KDP crystals; inner-shell photo-ionized X-ray lasers; X-ray radiographic measurements of radiation-driven shock and interface motion in solid density materials; themore » role of nodule defects in laser-induced damage of multilayer optical coatings; techniques for Mbar to near-Gbar equation-of-state measurements with the Nova laser; parametric instabilities and laser-beam smoothing.« less

  8. Computer modeling and simulation in inertial confinement fusion

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McCrory, R.L.; Verdon, C.P.

    1989-03-01

    The complex hydrodynamic and transport processes associated with the implosion of an inertial confinement fusion (ICF) pellet place considerable demands on numerical simulation programs. Processes associated with implosion can usually be described using relatively simple models, but their complex interplay requires that programs model most of the relevant physical phenomena accurately. Most hydrodynamic codes used in ICF incorporate a one-fluid, two-temperature model. Electrons and ions are assumed to flow as one fluid (no charge separation). Due to the relatively weak coupling between the ions and electrons, each species is treated separately in terms of its temperature. In this paper wemore » describe some of the major components associated with an ICF hydrodynamics simulation code. To serve as an example we draw heavily on a two-dimensional Lagrangian hydrodynamic code (ORCHID) written at the University of Rochester's Laboratory for Laser Energetics. 46 refs., 19 figs., 1 tab.« less

  9. FY14 LLNL OMEGA Experimental Programs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Heeter, R. F.; Fournier, K. B.; Baker, K.

    In FY14, LLNL’s High-Energy-Density Physics (HED) and Indirect Drive Inertial Confinement Fusion (ICF-ID) programs conducted several campaigns on the OMEGA laser system and on the EP laser system, as well as campaigns that used the OMEGA and EP beams jointly. Overall these LLNL programs led 324 target shots in FY14, with 246 shots using just the OMEGA laser system, 62 shots using just the EP laser system, and 16 Joint shots using Omega and EP together. Approximately 31% of the total number of shots (62 OMEGA shots, 42 EP shots) shots supported the Indirect Drive Inertial Confinement Fusion Campaign (ICF-ID).more » The remaining 69% (200 OMEGA shots and 36 EP shots, including the 16 Joint shots) were dedicated to experiments for High- Energy-Density Physics (HED). Highlights of the various HED and ICF campaigns are summarized in the following reports.« less

  10. 1 Hz fast-heating fusion driver HAMA pumped by a 10 J green diode-pumped solid-state laser

    NASA Astrophysics Data System (ADS)

    Mori, Y.; Sekine, T.; Komeda, O.; Nakayama, S.; Ishii, K.; Hanayama, R.; Fujita, K.; Okihara, S.; Satoh, N.; Kurita, T.; Kawashima, T.; Kan, H.; Nakamura, N.; Kondo, T.; Fujine, M.; Azuma, H.; Hioki, T.; Kakeno, M.; Motohiro, T.; Nishimura, Y.; Sunahara, A.; Sentoku, Y.; Kitagawa, Y.

    2013-07-01

    A Ti : sapphire laser HAMA pumped by a diode-pumped solid-state laser (DPSSL) is developed to enable a high-repetitive inertial confinement fusion (ICF) experiment to be conducted. To demonstrate a counter-irradiation fast-heating fusion scheme, a 3.8 J, 0.4 ns amplified chirped pulse is divided into four beams: two counter-irradiate a target with intensities of 6 × 1013 W cm-2, and the remaining two are pulse-compressed to 110 fs for heating the imploded target with intensities of 2 × 1017 W cm-2. HAMA contributed to the first demonstration by showing that a 10 J class DPSSL is adaptable to ICF experiments and succeeded in DD neutron generation in the repetition mode. Based on HAMA, we can design and develop an integrated repetitive ICF experiment machine by including target injection and tracking.

  11. Inertial Confinement Fusion and the National Ignition Facility (NIF)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ross, P.

    2012-08-29

    Inertial confinement fusion (ICF) seeks to provide sustainable fusion energy by compressing frozen deuterium and tritium fuel to extremely high densities. The advantages of fusion vs. fission are discussed, including total energy per reaction and energy per nucleon. The Lawson Criterion, defining the requirements for ignition, is derived and explained. Different confinement methods and their implications are discussed. The feasibility of creating a power plant using ICF is analyzed using realistic and feasible numbers. The National Ignition Facility (NIF) at Lawrence Livermore National Laboratory is shown as a significant step forward toward making a fusion power plant based on ICF.more » NIF is the world’s largest laser, delivering 1.8 MJ of energy, with a peak power greater than 500 TW. NIF is actively striving toward the goal of fusion energy. Other uses for NIF are discussed.« less

  12. FY15 LLNL OMEGA Experimental Programs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Heeter, R. F.; Baker, K. L.; Barrios, M. A.

    In FY15, LLNL’s High-Energy-Density Physics (HED) and Indirect Drive Inertial Confinement Fusion (ICF-ID) programs conducted several campaigns on the OMEGA laser system and on the EP laser system, as well as campaigns that used the OMEGA and EP beams jointly. Overall these LLNL programs led 468 target shots in FY15, with 315 shots using just the OMEGA laser system, 145 shots using just the EP laser system, and 8 Joint shots using Omega and EP together. Approximately 25% of the total number of shots (56 OMEGA shots and 67 EP shots, including the 8 Joint shots) supported the Indirect Drivemore » Inertial Confinement Fusion Campaign (ICF-ID). The remaining 75% (267 OMEGA shots and 86 EP shots) were dedicated to experiments for High-Energy-Density Physics (HED). Highlights of the various HED and ICF campaigns are summarized in the following reports.« less

  13. Postural stability in patients with knee osteoarthritis: comparison with controls and evaluation of relationships between postural stability scores and International Classification of Functioning, Disability and Health components.

    PubMed

    Hsieh, Ru-Lan; Lee, Wen-Chung; Lo, Min-Tzu; Liao, Wei-Cheng

    2013-02-01

    To assess the differences in postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis, and to evaluate possible relations between postural stability scores and International Classification of Functioning, Disability and Health (ICF) components. An age-matched, case-controlled trial with a cross-sectional design. A teaching hospital. Patients with knee osteoarthritis (n=73) and age-matched controls (n=60). Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relation between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the World Health Organization Quality of Life Brief Version (62.2 vs 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=.33-.34, P=.004), physical fatigue (r=.28, P=.016), and reduced motivation (r=.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included reduced activity (r=.38, P=.001), physical domain and function (r=.34-.48, P=.001 to P<.004), activities of daily living (r=.51, P<.001), and sports and recreation (r=.35, P=.003). A moderate association between postural stability and the ICF components of personal and environmental factors was observed, including age (r=.52, P<.001) and quality of life (r=0.4, P=.001). Patients with knee osteoarthritis displayed lower postural stability and achieved lower scores in the environmental domain of quality-of-life measures than did controls. The postural stability of patients with knee osteoarthritis was weakly to moderately associated with the following ICF components: body functions and structures, activities and participation, and personal and environmental factors. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Using Rasch rating scale model to reassess the psychometric properties of the Persian version of the PedsQL™ 4.0 Generic Core Scales in school children.

    PubMed

    Jafari, Peyman; Bagheri, Zahra; Ayatollahi, Seyyed Mohamad Taghi; Soltani, Zahra

    2012-03-13

    Item response theory (IRT) is extensively used to develop adaptive instruments of health-related quality of life (HRQoL). However, each IRT model has its own function to estimate item and category parameters, and hence different results may be found using the same response categories with different IRT models. The present study used the Rasch rating scale model (RSM) to examine and reassess the psychometric properties of the Persian version of the PedsQL™ 4.0 Generic Core Scales. The PedsQL™ 4.0 Generic Core Scales was completed by 938 Iranian school children and their parents. Convergent, discriminant and construct validity of the instrument were assessed by classical test theory (CTT). The RSM was applied to investigate person and item reliability, item statistics and ordering of response categories. The CTT method showed that the scaling success rate for convergent and discriminant validity were 100% in all domains with the exception of physical health in the child self-report. Moreover, confirmatory factor analysis supported a four-factor model similar to its original version. The RSM showed that 22 out of 23 items had acceptable infit and outfit statistics (<1.4, >0.6), person reliabilities were low, item reliabilities were high, and item difficulty ranged from -1.01 to 0.71 and -0.68 to 0.43 for child self-report and parent proxy-report, respectively. Also the RSM showed that successive response categories for all items were not located in the expected order. This study revealed that, in all domains, the five response categories did not perform adequately. It is not known whether this problem is a function of the meaning of the response choices in the Persian language or an artifact of a mostly healthy population that did not use the full range of the response categories. The response categories should be evaluated in further validation studies, especially in large samples of chronically ill patients.

  15. Continuations of the nonlinear Schrödinger equation beyond the singularity

    NASA Astrophysics Data System (ADS)

    Fibich, G.; Klein, M.

    2011-07-01

    We present four continuations of the critical nonlinear Schrödinger equation (NLS) beyond the singularity: (1) a sub-threshold power continuation, (2) a shrinking-hole continuation for ring-type solutions, (3) a vanishing nonlinear-damping continuation and (4) a complex Ginzburg-Landau (CGL) continuation. Using asymptotic analysis, we explicitly calculate the limiting solutions beyond the singularity. These calculations show that for generic initial data that lead to a loglog collapse, the sub-threshold power limit is a Bourgain-Wang solution, both before and after the singularity, and the vanishing nonlinear-damping and CGL limits are a loglog solution before the singularity, and have an infinite-velocity expanding core after the singularity. Our results suggest that all NLS continuations share the universal feature that after the singularity time Tc, the phase of the singular core is only determined up to multiplication by eiθ. As a result, interactions between post-collapse beams (filaments) become chaotic. We also show that when the continuation model leads to a point singularity and preserves the NLS invariance under the transformation t → -t and ψ → ψ*, the singular core of the weak solution is symmetric with respect to Tc. Therefore, the sub-threshold power and the shrinking-hole continuations are symmetric with respect to Tc, but continuations which are based on perturbations of the NLS equation are generically asymmetric.

  16. A LabVIEW® based generic CT scanner control software platform.

    PubMed

    Dierick, M; Van Loo, D; Masschaele, B; Boone, M; Van Hoorebeke, L

    2010-01-01

    UGCT, the Centre for X-ray tomography at Ghent University (Belgium) does research on X-ray tomography and its applications. This includes the development and construction of state-of-the-art CT scanners for scientific research. Because these scanners are built for very different purposes they differ considerably in their physical implementations. However, they all share common principle functionality. In this context a generic software platform was developed using LabVIEW® in order to provide the same interface and functionality on all scanners. This article describes the concept and features of this software, and its potential for tomography in a research setting. The core concept is to rigorously separate the abstract operation of a CT scanner from its actual physical configuration. This separation is achieved by implementing a sender-listener architecture. The advantages are that the resulting software platform is generic, scalable, highly efficient, easy to develop and to extend, and that it can be deployed on future scanners with minimal effort.

  17. Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 1: Generic ground operations data

    NASA Technical Reports Server (NTRS)

    Byrd, Raymond J.

    1990-01-01

    This study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advance Launch System (ALS) program, the results of the Operationally Efficient Propulsion System Study (OEPSS) were organized into a series of OEPSS Data Books as follows: Volume 1, Generic Ground Operations Data; Volume 2, Ground Operations Problems; Volume 3, Operations Technology; Volume 4, OEPSS Design Concepts; and Volume 5, OEPSS Final Review Briefing, which summarizes the activities and results of the study. This volume presents ground processing data for a generic LOX/LH2 booster and core propulsion system based on current STS experience. The data presented includes: top logic diagram, process flow, activities bar-chart, loaded timelines, manpower requirements in terms of duration, headcount and skill mix per operations and maintenance instruction (OMI), and critical path tasks and durations.

  18. Inertial Confinement Fusion Annual Report 1999

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kauffman, Robert L.

    The ICF Program has undergone a significant change in 1999 with the decommissioning of the Nova laser and the transfer of much of the experimental program to the OMEGA laser at the University of Rochester. The Nova laser ended operations with the final experiment conducted on May 27, 1999. This marked the end to one of DOE's most successful experimental facilities. Since its commissioning in 1985, Nova performed 13,424 experiments supporting ICF, Defense Sciences, high-power laser research, and basic science research. At the time of its commissioning, Nova was the world's most powerful laser. Its early experiments demonstrated that 3ωmore » light could produce high-drive, low-preheat environment required for indirect-drive ICE. In the early 1990s, the technical program on Nova for indirect drive ignition was defined by the Nova technical contract established by National Academy Review of ICF in 1990. Successful completion of this research program contributed significantly to the recommendation by the ICF Advisory Committee in 1995 to proceed with the construction of the National Ignition Facility? Nova experiments also demonstrated the utility of high-powered lasers for studying the physics of interest to Defense Sciences. Now, high-powered lasers along with pulsed-power machines are the principal facilities for studying high energy density science in DOE's Stockpile Stewardship Program (SSP). In 1997, one beam of Nova was converted to a short pulsed beam producing a petawatt of power in subpicosecond pulses. The petawatt beam was used for pioneering research in short-pulse laser-matter interactions relevant to fast ignitor ICF and short pulsed x-ray, electron, and particle production for use as probes. Nova is being disassembled and the space is being used to support NIF construction. Nova components are being distributed to a number of other laser laboratories around the world for reuse as determined by DOE. This report summarizes the research performed by the ICF Program in FY1999. The report is divided into five sections corresponding to the major areas of program activities. These are sections on (1) ignition target physics experiments theory and modeling, (2) high energy density experimental science, (3) target development, fabrication, and handling, (4) NIF laser development, and (5) optics technology development.« less

  19. D-Cluster Converter Foil for Laser-Accelerated Deuteron Beams: Towards Deuteron-Beam-Driven Fast Ignition

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Miley, George H.

    Fast Ignition (FI) uses Petawatt laser generated particle beam pulse to ignite a small volume called a pre-compressed Inertial Confinement Fusion (ICF) target, and is the favored method to achieve the high energy gain per target burn needed for an attractive ICF power plant. Ion beams such as protons, deuterons or heavier carbon ions are especially appealing for FI as they have relative straight trajectory, and easier to focus on the fuel capsule. But current experiments have encountered problems with the 'converter-foil' which is irradiated by the Petawatt laser to produce the ion beams. The problems include depletion of themore » available ions in the convertor foils, and poor energy efficiency (ion beam energy/ input laser energy). We proposed to develop a volumetrically-loaded ultra-high-density deuteron deuterium cluster material as the basis for converter-foil for deuteron beam generation. The deuterons will fuse with the ICF DT while they slow down, providing an extra 'bonus' energy gain in addition to heating the hot spot. Also, due to the volumetric loading, the foil will provide sufficient energetic deuteron beam flux for 'hot spot' ignition, while avoiding the depletion problem encountered by current proton-driven FI foils. After extensive comparative studies, in Phase I, high purity PdO/Pd/PdO foils were selected for the high packing fraction D-Cluster converter foils. An optimized loading process has been developed to increase the cluster packing fraction in this type of foil. As a result, the packing fraction has been increased from 0.1% to 10% - meeting the original Phase I goal and representing a significant progress towards the beam intensities needed for both FI and pulsed neutron applications. Fast Ignition provides a promising approach to achieve high energy gain target performance needed for commercial Inertial Confinement Fusion (ICF). This is now a realistic goal for near term in view of the anticipated ICF target burn at the National Ignition Facility (NIF) in CA within a year. This will usher in the technology development Phase of ICF after years of research aimed at achieving breakeven experiment. Methods to achieve the high energy gain needed for a competitive power plant will then be a key developmental issue, and our D-cluster target for Fast Ignition (FI) is expected to meet that need.« less

  20. Dementia skills for all: a core competency framework for the workforce in the United Kingdom.

    PubMed

    Tsaroucha, Anna; Benbow, Susan Mary; Kingston, Paul; Le Mesurier, Nick

    2013-01-01

    One of the biggest challenges facing health and social care in the United Kingdom is the projected increase in the number of older people who require dementia care. The National Dementia Strategy (Department of Health, 2009) emphasizes the critical need for a skilled workforce in all aspects of dementia care. In the West Midlands, the Strategic Health Authority commissioned a project to develop a set of generic core competencies that would guide a competency based curriculum to meet the demands for improved dementia training and education. A systematic literature search was conducted to identify relevant frameworks to assist with this work. The core competency framework produced and the methods used for the development of the framework are presented and discussed.

  1. Assessment of fatigue using the Identity-Consequence Fatigue Scale in patients with lung cancer.

    PubMed

    Nogueira, Ingrid Correia; Araújo, Amanda Souza; Morano, Maria Tereza; Cavalcante, Antonio George; Bruin, Pedro Felipe de; Paddison, Johana Susan; Silva, Guilherme Pinheiro da; Pereira, Eanes Delgado

    2017-01-01

    To evaluate the properties of the Identity-Consequence Fatigue Scale (ICFS) in patients with lung cancer (LC), assessing the intensity of fatigue and associated factors. This was a cross-sectional study involving LC patients, treated at a teaching hospital in Brazil, who completed the ICFS. Patients with chronic heart disease (CHD) and healthy controls, matched for age and gender, also completed the scale. Initially, a Brazilian Portuguese-language version of the ICFS was administered to 50 LC patients by two independent interviewers; to test for reproducibility, it was readministered to those same patients. At baseline, the LC patients were submitted to spirometry and the six-minute walk test, as well as completing the Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), and Fatigue Severity Scale (FSS). Inflammatory status was assessed by blood C-reactive protein (CRP) levels. To validate the ICFS, we assessed the correlations of its scores with those variables. The sample comprised 50 patients in each group (LC, CHD, and control). In the LC group, the intraclass correlation coefficients for intra-rater and inter-rater reliability regarding ICFS summary variables ranged from 0.94 to 0.76 and from 0.94 to 0.79, respectively. The ICFS presented excellent internal consistency, and Bland-Altman plots showed good test-retest reliability. The ICFS correlated significantly with FSS, HADS, and SF-36 scores, as well as with CRP levels. Mean ICFS scores in the LC group differed significantly from those in the CHD and control groups. The ICFS is a valid, reliable instrument for evaluating LC patients, in whom depression, quality of life, and CRP levels seem to be significantly associated with fatigue. Avaliar as propriedades da Escala de Identificação e Consequências da Fadiga (EICF) em pacientes com câncer de pulmão (CP), analisando a intensidade da fadiga e fatores associados. Estudo transversal com pacientes com CP, atendidos em um hospital-escola no Brasil, que preencheram a EICF. Pacientes com doenças cardíacas crônicas (DCC) e controles saudáveis, pareados por idade e sexo, também preencheram a escala. Inicialmente, uma versão brasileira da escala foi aplicada a 50 pacientes com CP por dois entrevistadores independentes; para testar a reprodutibilidade, ela foi reaplicada aos mesmos pacientes. No momento basal, os pacientes com CP realizaram espirometria e teste de caminhada de seis minutos, bem como preencheram a Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) e Fatigue Severity Scale (FSS). O estado inflamatório foi avaliado pelos níveis de proteína C reativa (PCR) no sangue. Para validar a EICF, avaliamos as correlações entre as pontuações na mesma e essas variáveis. A amostra foi composta por 50 pacientes em cada grupo (CP, DCC e controle). No grupo CP, os coeficientes de correlação intraclasse para confiabilidade intra e interobservador para as variáveis resumidas da EICF variaram de 0,94 a 0,76 e de 0,94 a 0,79, respectivamente. A EICF apresentou excelente consistência interna, e as disposições gráficas de Bland-Altman demonstraram boa confiabilidade teste-reteste. A EICF apresentou correlações significativas com as pontuações na FSS, HADS e SF-36, bem como com os níveis de PCR. As médias das pontuações na EICF do grupo CP diferiram significativamente das dos grupos DCC e controle. A EICF é um instrumento válido e confiável para a avaliação de pacientes com CP, nos quais depressão, qualidade de vida e níveis de PCR parecem estar significativamente associados à fadiga.

  2. Preparing Brigade Combat Team Soldiers for Mission Readiness Through Research on Intangible Psychological Constructs and their Applications: Validation and Pilot

    DTIC Science & Technology

    2015-01-01

    and their Applications: Validation and Pilot Steven N. Aude Kenneth Nicely Michael A. Lodato ICF International Christopher L. Vowels...CONTRACT OR GRANT NUMBER W5J9CQ-11-0009 5b. PROGRAM ELEMENT NUMBER 622785 6. AUTHOR(S) Steven N. Aude, Kenneth Nicely, Michael A... Michael A. Lodato ICF International Christopher L. Vowels U.S. Army Research Institute Fort Hood Research Unit Brian T. Crabb

  3. Inertial Confinement fusion targets

    NASA Technical Reports Server (NTRS)

    Hendricks, C. D.

    1982-01-01

    Inertial confinement fusion (ICF) targets are made as simple flat discs, as hollow shells or as complicated multilayer structures. Many techniques were devised for producing the targets. Glass and metal shells are made by using drop and bubble techniques. Solid hydrogen shells are also produced by adapting old methods to the solution of modern problems. Some of these techniques, problems, and solutions are discussed. In addition, the applications of many of the techniques to fabrication of ICF targets is presented.

  4. DOE ZERH Case Study: Greenhill Contracting, Green Acres #20, #26, #28, New Paltz, NY

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    none,

    2015-09-01

    Case study of three DOE 2015 Housing Innovation Award winning custom homes in the cold climate that got a HERS of 26, 28, and 26 without PV or -3, -1, and -3.5 with PV; with R-22 ICFs, 10” ocsf plus 2.7” c ccsf in attic; ICF basements with 4.3” ccsf under slab; tri;e-pane windows; ERVs, ground source heat pumps (COP 5.7).

  5. Mapping SAGE questionnaire to the International Classification of Functioning, Disability and Health (ICF).

    PubMed

    Raggi, Alberto; Quintas, Rui; Russo, Emanuela; Martinuzzi, Andrea; Costardi, Daniela; Frisoni, Giovanni Battista; Franco, Maria Grazia; Andreotti, Alessandra; Ojala, Matti; Peña, Sebastián; Perales, Jaime; Chatterji, Somnath; Miret, Marta; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Frattura, Lucilla; Leonardi, Matilde

    2014-01-01

    The collaborative research on ageing in Europe protocol was based on that of the World Health Organization Study on global AGEing and adult health (SAGE) project that investigated the relationship between health and well-being and provided a set of instruments that can be used across countries to monitor health and health-related outcomes of older populations as well as the strategies for addressing issues concerning the ageing process. To evaluate the degree to which SAGE protocol covered the spectrum of disability given the scope of the World Health Organization International Classification of Functioning, Disability and Health (ICF), a mapping exercise was performed with SAGE protocol. Results show that the SAGE protocol covers ICF domains in a non-uniform way, with environmental factors categories being underrepresented, whereas mental, cardiovascular, sensory functions and mobility were overrepresented. To overcome this partial coverage of ICF functioning categories, new assessment instruments have been developed. PRACTITIONER MESSAGE: Mapping exercises are valid procedures to understand the extent to which a survey protocol covers the spectrum of functioning. The mapping exercise with SAGE protocol shows that it provides only a partial representation of body functions and activities and participation domains, and the coverage of environmental factors is poor. New instruments are therefore needed for researchers to properly understand the health and disability of ageing populations. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Application of WHO recommendations in outcome assessment of clinical series published in hand surgery journals with five years interval.

    PubMed

    Alarab, H; Dubert, T

    2015-02-01

    Outcome measurement is becoming increasingly important in hand surgery. The International classification of functioning, disability and health (ICF), is a WHO multi-dimensional approach to health condition including three domains: body "functions and structures", activities and participation. The aim of this study was to measure how often these three ICF domains were included in outcome measurements of the clinical series published in the American, European and French hand surgery journals. Our study included clinical series published in 2007 and 2012 in the American Journal Of Hand Surgery, European Journal Of Hand Surgery and Chirurgie de la Main. Analysis of each of these publications was done in two steps. First, we checked the presence or absence of the three domains of ICF in outcome measurement without considering the way it was measured. Then, we reported the use of evaluation instruments and/or quantitative measurement for each domain. We included 54 series in 2007 and 119 in 2012. The number of series reporting on the three domains and using at least one quantitative measurement for each domain represents 6% of articles in 2007 and 10% in 2012. This study shows that the quality of outcome measurement has improved over these 5 years, but remains poor according to the ICF recommendation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Compact torus accelerator as a driver for ICF

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tobin, M.T.; Meier, W.R.; Morse, E.C.

    1986-01-01

    The authors have carried out further investigations of the technical issues associated with using a compact torus (CT) accelerator as a driver for inertial confinement fusion (ICF). In a CT accelerator, a magnetically confined, torus-shaped plasma is compressed, accelerated, and focused by two concentric electrodes. After its initial formation, the torus shape is maintained for lifetimes exceeding 1 ms by inherent poloidal and toroidal currents. Hartman suggests acceleration and focusing of such a plasma ring will not cause dissolution within certain constraints. In this study, we evaluated a point design based on an available capacitor bank energy of 9.2 MJ.more » This accelerator, which was modeled by a zero-dimensional code, produces a xenon plasma ring with a 0.73-cm radius, a velocity of 4.14 x 10/sup 9/ cm/s, and a mass of 4.42 ..mu..g. The energy of the plasma ring as it leaves the accelerator is 3.8 MJ, or 41% of the capacitor bank energy. Our studies confirm the feasibility of producing a plasma ring with the characteristics required to induce fusion in an ICF target with a gain greater than 50. The low cost and high efficiency of the CT accelerator are particularly attractive. Uncertainties concerning propagation, accelerator lifetime, and power supply must be resolved to establish the viability of the accelerator as an ICF driver.« less

  8. The ICF: International Classification of Functioning, Disability and Health (ICF)--a Swiss army knife? Accessibility and disability in a Scandinavian disability magazine (SDM)--a quantitative content analysis.

    PubMed

    Lundälv, Jörgen; Larsson, Per-Olof; Törnbom, Marie; Sunnerhagen, Katharina Stibrant

    2012-11-01

    The study describes the extent to which the concept of accessibility and accessibility issues has been reported in a national Scandinavian disability magazine. In this study particular attention is paid to how the compatibility between the various domains of the international classification - International Classification of Functioning, Disability and Health (ICF) - has been covered in the magazine over a decade. Furthermore, other types of descriptions that the magazine has made of accessibility for people with physical disabilities are considered. The study is based on a quantitative content analysis of a total of 326 articles from the Swedish disability magazine (SDM); 450 text pages published during the years 2000-2009. The magazine's coverage has been comprehensive. More than half of the studied texts were news items about various accessibility issues. Every third article can be characterised as a news article or feature article. The most frequently reported of the ICF domains consist of two perspectives: environmental accessibility and civil rights. Public opinion articles in the form of letters to editors and editorials focused on accessibility have a low frequency. Likewise, research reports are few. The study has included a review of illustrations and photographs. The illustrations are generally of high quality, reinforcing the disability message of the article. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Description of movement quality in patients with low back pain: A qualitative study as a first step to a practical definition.

    PubMed

    van Dijk, Margriet J H; Smorenburg, Nienke T A; Visser, Bart; Nijhuis-van der Sanden, Maria W G; Heerkens, Yvonne F

    2017-03-01

    As a first step to formulate a practical definition for movement quality (MQ), this study aims to explore how Dutch allied health care professionals (AHCPs) describe MQ of daily life activities in patients with low back pain (LBP). In this qualitative cross-sectional digital survey study, Dutch AHCPs (n = 91) described MQ in open text (n = 91) and with three keywords (n = 90). After exploratory qualitative content analysis, the ICF linking rules (International Classification of Functioning, Disability and Health) were applied to classify MQ descriptions and keywords. The identified meaningful concepts (MCs) of the descriptions (274) and keywords (239) were linked to ICF codes (87.5% and 80.3%, respectively), Personal factors (5.8% and 5.9%, respectively), and supplementary codes (6.6% and 13.8%, respectively). The MCs were linked to a total of 31 ICF codes, especially to b760 'control of voluntary movement functions', b7602 'coordination of voluntary movements', d4 'Mobility', and d230 'carry out daily routine'. Negative and positive formulated descriptions elucidated different MQ interpretations. Descriptions of MQ given by Dutch AHCPs in patients with LBP cover all ICF components. Coordination and functional movements are seen as the most elementary concepts of MQ. Variation in MQ descriptions and interpretations hinders defining MQ and indicates the necessity of additional steps.

  10. In Search of Museum Professional Knowledge Base: Mapping the Professional Knowledge Debate onto Museum Work

    ERIC Educational Resources Information Center

    Tlili, Anwar

    2016-01-01

    Museum professionalism remains an unexplored area in museum studies, particularly with regard to what is arguably the core generic question of a "sui generis" professional knowledge base, and its necessary and sufficient conditions. The need to examine this question becomes all the more important with the increasing expansion of the…

  11. An Integrated Academic Literacy Approach to Improving Students' Understanding of Plagiarism in an Accounting Course

    ERIC Educational Resources Information Center

    Powell, Lisa; Singh, Nishani

    2016-01-01

    Plagiarism in higher education is a widespread and complex issue. Students' understanding of plagiarism differs as a result of combining their prior learning about referencing with their current experience of institutional policies and generic resources. Plagiarism was identified as a major learning issue in a core second-year undergraduate…

  12. System Framework for a Multi-Band, Multi-Mode Software Defined Radio

    DTIC Science & Technology

    2014-06-01

    detection, while the VITA Radio Transport ( VRT ) protocol over Gigabit Ethernet (GIGE) is implemented for the data interface. In addition to the SoC...CTRL VGA CTRL C2 GPP C2 CORE SW ARM0 RX SYN CTRL PL MEMORY MAP DR CTRL GENERIC INTERRUPT CONTROLLER DR GPP VITERBI ALGORITHM & VRT INTERFACE ARM1

  13. A K-6 Computational Thinking Curriculum Framework: Implications for Teacher Knowledge

    ERIC Educational Resources Information Center

    Angeli, Charoula; Voogt, Joke; Fluck, Andrew; Webb, Mary; Cox, Margaret; Malyn-Smith, Joyce; Zagami, Jason

    2016-01-01

    Adding computer science as a separate school subject to the core K-6 curriculum is a complex issue with educational challenges. The authors herein address two of these challenges: (1) the design of the curriculum based on a generic computational thinking framework, and (2) the knowledge teachers need to teach the curriculum. The first issue is…

  14. In search of late time evolution self-similar scaling laws of Rayleigh-Taylor and Richtmyer-Meshkov hydrodynamic instabilities - recent theorical advance and NIF Discovery-Science experiments

    NASA Astrophysics Data System (ADS)

    Shvarts, Dov

    2017-10-01

    Hydrodynamic instabilities, and the mixing that they cause, are of crucial importance in describing many phenomena, from very large scales such as stellar explosions (supernovae) to very small scales, such as inertial confinement fusion (ICF) implosions. Such mixing causes the ejection of stellar core material in supernovae, and impedes attempts at ICF ignition. The Rayleigh-Taylor instability (RTI) occurs at an accelerated interface between two fluids with the lower density accelerating the higher density fluid. The Richtmyer-Meshkov (RM) instability occurs when a shock wave passes an interface between the two fluids of different density. In the RTI, buoyancy causes ``bubbles'' of the light fluid to rise through (penetrate) the denser fluid, while ``spikes'' of the heavy fluid sink through (penetrate) the lighter fluid. With realistic multi-mode initial conditions, in the deep nonlinear regime, the mixing zone width, H, and its internal structure, progress through an inverse cascade of spatial scales, reaching an asymptotic self-similar evolution: hRT =αRT Agt2 for RT and hRM =αRM tθ for RM. While this characteristic behavior has been known for years, the self-similar parameters αRT and θRM and their dependence on dimensionality and density ratio have continued to be intensively studied and a relatively wide distribution of those values have emerged. This talk will describe recent theoretical advances in the description of this turbulent mixing evolution that sheds light on the spread in αRT and θRM. Results of new and specially designed experiments, done by scientists from several laboratories, were performed recently using NIF, the only facility that is powerful enough to reach the self-similar regime, for quantitative testing of this theoretical advance, will be presented.

  15. Scalable and Power Efficient Data Analytics for Hybrid Exascale Systems

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Choudhary, Alok; Samatova, Nagiza; Wu, Kesheng

    This project developed a generic and optimized set of core data analytics functions. These functions organically consolidate a broad constellation of high performance analytical pipelines. As the architectures of emerging HPC systems become inherently heterogeneous, there is a need to design algorithms for data analysis kernels accelerated on hybrid multi-node, multi-core HPC architectures comprised of a mix of CPUs, GPUs, and SSDs. Furthermore, the power-aware trend drives the advances in our performance-energy tradeoff analysis framework which enables our data analysis kernels algorithms and software to be parameterized so that users can choose the right power-performance optimizations.

  16. High-order hydrodynamic algorithms for exascale computing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Morgan, Nathaniel Ray

    Hydrodynamic algorithms are at the core of many laboratory missions ranging from simulating ICF implosions to climate modeling. The hydrodynamic algorithms commonly employed at the laboratory and in industry (1) typically lack requisite accuracy for complex multi- material vortical flows and (2) are not well suited for exascale computing due to poor data locality and poor FLOP/memory ratios. Exascale computing requires advances in both computer science and numerical algorithms. We propose to research the second requirement and create a new high-order hydrodynamic algorithm that has superior accuracy, excellent data locality, and excellent FLOP/memory ratios. This proposal will impact a broadmore » range of research areas including numerical theory, discrete mathematics, vorticity evolution, gas dynamics, interface instability evolution, turbulent flows, fluid dynamics and shock driven flows. If successful, the proposed research has the potential to radically transform simulation capabilities and help position the laboratory for computing at the exascale.« less

  17. LATIS3D: The Goal Standard for Laser-Tissue-Interaction Modeling

    NASA Astrophysics Data System (ADS)

    London, R. A.; Makarewicz, A. M.; Kim, B. M.; Gentile, N. A.; Yang, T. Y. B.

    2000-03-01

    The goal of this LDRD project has been to create LATIS3D-the world's premier computer program for laser-tissue interaction modeling. The development was based on recent experience with the 2D LATIS code and the ASCI code, KULL. With LATIS3D, important applications in laser medical therapy were researched including dynamical calculations of tissue emulsification and ablation, photothermal therapy, and photon transport for photodynamic therapy. This project also enhanced LLNL's core competency in laser-matter interactions and high-energy-density physics by pushing simulation codes into new parameter regimes and by attracting external expertise. This will benefit both existing LLNL programs such as ICF and SBSS and emerging programs in medical technology and other laser applications. The purpose of this project was to develop and apply a computer program for laser-tissue interaction modeling to aid in the development of new instruments and procedures in laser medicine.

  18. SU-E-T-285: Dose Variation at Bone in Small-Animal Irradiation: A Monte Carlo Study Using Monoenergetic Photon Beams

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vuong, A; Chow, J

    Purpose: The aim of this study is to investigate the variation of bone dose on photon beam energy (keV – MeV) in small-animal irradiation. Dosimetry of homogeneous and inhomogeneous phantoms as per the same mouse computed tomography image set were calculated using the DOSCTP and DOSXYZnrc based on the EGSnrc Monte Carlo code. Methods: Monte Carlo simulations for the homogeneous and inhomogeneous mouse phantom irradiated by a 360 degree photon arc were carried out. Mean doses of the bone tissue in the irradiated volumes were calculated at various photon beam energies, ranging from 50 keV to 1.25 MeV. The effectmore » of bone inhomogeneity was examined through the Inhomogeneous Correction Factor (ICF), a dose ratio of the inhomogeneous to the homogeneous medium. Results: From our Monte Carlo results, higher mean bone dose and ICF were found when using kilovoltage photon beams compared to megavoltage. In beam energies ranging from 50 keV to 200 keV, the bone dose was found maximum at 50 keV, and decreased significantly from 2.6 Gy to 0.55 Gy, when 2 Gy was delivered at the center of the phantom (isocenter). Similarly, the ICF were found decreasing from 4.5 to 1 when the photon beam energy was increased from 50 keV to 200 keV. Both mean bone dose and ICF remained at about 0.5 Gy and 1 from 200 keV to 1.25 MeV with insignificant variation, respectively. Conclusion: It is concluded that to avoid high bone dose in the small-animal irradiation, photon beam energy higher than 200 keV should be used with the ICF close to one, and bone dose comparable to the megavoltage beam where photoelectric effect is not dominant.« less

  19. Third-party disability in carers of people with dysphagia following non-surgical management for head and neck cancer.

    PubMed

    Nund, Rebecca L; Scarinci, Nerina A; Cartmill, Bena; Ward, Elizabeth C; Kuipers, Pim; Porceddu, Sandro V

    2016-01-01

    Third-party disability pertains to the consequences of a person's impairment which impacts on the functioning and ability of their family members or significant others. With the emergence of research demonstrating the pervasive effects of dysphagia following head and neck cancer (HNC) on the carer, the aim of this study was to identify the International Classification of Functioning, Disability and Health (ICF) domains and categories that describe the third-party disability of carers of people with dysphagia following HNC. Twelve carers of people with dysphagia following HNC participated in individual semi-structured, in-depth interviews. Categories and sub-categories identified from the qualitative analysis were mapped to the ICF using the established linking rules. The majority of the categories and sub-categories from the qualitative analysis were successfully linked to the ICF with most linking to the Activities and Participation component. A number of contextual factors were also identified as impacting on the functioning of carers. The ICF can be successfully used to describe the third-party disability in carers of people with dysphagia following HNC management. This information could be used by clinicians, researchers and policy makers to help establish evidence-based guidelines that include carers in the assessment and management of dysphagia associated with HNC. Clinical levels of distress and reduced quality of life have been associated with caring for a person with dysphagia following head and neck cancer. The flow-on effects of dysphagia experienced by a carer or close family member can be understood as a third-party disability, which impacts on their functioning, activities and participation in the context of the environment and personal factors. Using the ICF to describe the indirect effects of dysphagia on the carer may help to guide the assessment and support of this population, and advocate for the inclusion of the concerns of the carer in dysphagia management.

  20. Using the International Classification of Functioning, Disability and Health (ICF) to address facilitators and barriers to participation at work.

    PubMed

    Martins, Anabela Correia

    2015-01-01

    The International Classification of Functioning, Disability and Health (ICF) was approved by the World Health Assembly in 2001. Ten years later, strong arguments have arisen regarding the added value of ICF to the policies on employment and the outcomes at the workplace. As a conceptual framework, ICF has universality because of its inclusive and comprehensive view of human functioning. At a practical level ICF can be used to quantify the impact of impairment on an individual's ability to act in his/her environment and to assess interventions to minimize the impact of disability and maximize functioning. To explore key indicators of social participation (life habits) of persons with disabilities, particularly related to work, among environmental and personal factors. Data were collected by self-administered questionnaires from a convenience sample of 149 working-age persons with disabilities. Social participation is a construct composed by multiple components and employment domain is the strongest indicator of participation. Correlations between social participation and personal factors, such as self-efficacy and attitudes towards disability were moderate. Those who are employed scored higher quality of life in terms of satisfaction with life, more positive attitudes toward disabilities and higher self-efficacy than the ones who are retired or unemployed. Persons using adapted wheelchair and those who were involved in wheelchair selection scored higher in social participation in general, performance at work, and quality of life. Age and disability duration were not associated with participants' employment status. These findings suggest that rehabilitation and vocational agents, like physiotherapists and other professionals, should have knowledge and understanding of the multiple factors that influence persons with disabilities' participation at work. Programs should provide appropriate wheelchairs, skills training, empowerment and problem-solving strategies in labour activities and occupational environment to promote employment of working-age persons with disabilities.

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