Needs, problems and rehabilitation goals of young children with cerebral palsy as formulated in the rehabilitation activities profile for children

Objective: To describe the content of needs, problems and goals of 41 Dutch children with cerebral palsy using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a classification system. To evaluate the adherence of formulations of needs, problems and goals to specifications of the Rehabilitation Activities Profile for Children. Methods: Raw text data were extracted and organized. Two raters independently weighed the entries' quality against the specifications and linked the extracted content to ICF-CY categories. Results: In 12% of the reports no needs, and in 24% no principal goals, were formulated. Needs mostly pertained to the activities-and-participation domain (65%), whereas problems and goals covered all 3 ICF-CY domains. None of the needs were prioritized and 79% met the quality criterion of description of a problem/desire. Twenty-four percent of the problems were described in the activity-and-participation domain and 83% referred to a treatable problem. Fifty-six percent of the goals were formulated in terms of intended result/effect and 63% as child/parent actions. Conclusion: Insight is provided into the content of rehabilitation programmes for children with cerebral palsy. To optimize the quality of the reports, research on reasons for non-adherence to specifications of the Rehabilitation Activities Profile is needed

Characteristics of chronic non-specific musculoskeletal pain in children and adolescents attending a rheumatology outpatients clinic: a cross-sectional study

Background: Chronic non-specific musculoskeletal pain (CNSMSP) may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood. The purpose of the study was to build a biopsychosocial profile of children and adolescents with CNSMSP. Methods: CNSMSP subjects (n = 30, 18 females, age 7-18) were compared with age matched pain free controls across a number of biopsychosocial domains. Results: In the psychosocial domain CNSMSP subjects had increased levels of anxiety and depression, and had more somatic pain complaints. In the lifestyle domain CNSMSP subjects had lower physical activity levels, but no difference in television or computer use compared to pain free subjects. Physically, CNSMSP subjects tended to sit with a more slumped spinal posture, had reduced back muscle endurance, increased presence of joint hypermobility and poorer gross motor skills. Conclusion: These findings support the notion that CNSMSP is a multidimensional biopsychosocial disorder. Further research is needed to increase understanding of how the psychosocial, lifestyle and physical factors develop and interact in CNSMSP

Evaluation of the use of CD-ROM upload into the PACS or institutional web server

Purpose: Patient data are increasingly distributed between hospitals using CD-ROMs instead of actual films. This introduces problems because different viewers from different vendors are provided, and sometimes viewers are unusable because local software installation is not allowed. In 2004, we started to facilitate the incorporation of CD-ROM data into the normal workflow of the hospital by using commercially available software to perform patient reconciliation based on the DICOM (digital imaging and communication in medicine) modality worklist. The purpose of the current study is to evaluate this new procedure. Methods and Materials: A questionnaire was sent to all users to evaluate the satisfaction with the current facility and to evaluate possible improvements. Several quality parameters on speed and satisfaction were rated on a 5-point scale (1 = bad to 5 = excellent). Results: Replies from 17 different respondents were evaluated, accounting for an average of 76 CD-ROMs per week. Mean (median) results showed a score of 3.6 (4) for handling time, 3.4 (4) for archival of second opinion data, 3.8 (median 4) for archival of external data onto the web server, and 4.5 (median 5) for the overall performance of the current procedure. Conclusion: Although some improvements can be made, storage of the study data from CDs from outpatients into PACS (picture archiving and communication system) and web server already provides for an existing need. Using this service, physicians can access the data with ease and familiarity. User satisfaction with the provided solution is high