Assessing the Stroke-Specific Quality of Life for Outcome Measurement in Stroke Rehabilitation: Minimal Detectable Change and Clinically Important Difference

<p>Abstract</p> <p>Background</p> <p>This study was conducted to establish the minimal detectable change (MDC) and clinically important differences (CIDs) of the physical category of the Stroke-Specific Quality of Life Scale in patients with stroke.</p> <p>Methods</p> <p>MDC and CIDs scores were calculated from the data of 74 participants enrolled in randomized controlled trials investigating the effects of two rehabilitation programs in patients with stroke. These participants received treatments for 3 weeks and underwent clinical assessment before and after treatment. To obtain test-retest reliability for calculating MDC, another 25 patients with chronic stroke were recruited. The MDC was calculated from the standard error of measurement (SEM) to indicate a real change with 95% confidence for individual patients (MDC₉₅). Distribution-based and anchor-based methods were adopted to triangulate the ranges of minimal CIDs. The percentage of scale width was calculated by dividing the MDC and CIDs by the total score range of each physical category. The percentage of patients exceeding MDC₉₅and minimal CIDs was also reported.</p> <p>Results</p> <p>The MDC₉₅of the mobility, self-care, and upper extremity (UE) function subscales were 5.9, 4.0, and 5.3 respectively. The minimal CID ranges for these 3 subscales were 1.5 to 2.4, 1.2 to 1.9, and 1.2 to 1.8. The percentage of patients exceeding MDC₉₅and minimal CIDs of the mobility, self-care, and UE function subscales were 9.5% to 28.4%, 6.8% to 28.4%, and 12.2% to 33.8%, respectively.</p> <p>Conclusions</p> <p>The change score of an individual patient has to reach 5.9, 4.0, and 5.3 on the 3 subscales to indicate a true change. The mean change scores of a group of patients with stroke on these subscales should reach the lower bound of CID ranges of 1.5 (6.3% scale width), 1.2 (6.0% scale width), and 1.2 (6.0% scale width) to be regarded as clinically important change. This information may facilitate interpretations of patient-reported outcomes after stroke rehabilitation. Future research is warranted to validate these findings.</p

Solar Heating in Taiwan

AbstractSolar water heaters (SWHs) can provide hot water at temperatures ranging from 40 to 80oC for domestic or industrial use. With the subsidy programs (1986-1991 and 2000-present) offered by the Bureau of Energy, Ministry of Economic Affairs and some municipal governments, the accumulated area of solar collectors installed at the end of 2012 reached 2.25 million square meters. The well-orchestrated and concerted efforts put forward by the government of Taiwan, particularly with the Renewable Energy Development Bill promulgated in 2010, have played a significant role in the increased dissemination of SWHs. Further, the long-duration national subsidy programs might constitute one of the main driving forces for local market expansion. The mass media should be more aggressively utilized to enhance public awareness and promote utilization of SWHs. Organizations also need to consider the interests of society by being accountable for their businesses practices and by being responsible for the impact of their activities on the environment. This paper reports the current status and perspectives of SWHs in Taiwan, according to the desk and field surveys

Quantitative Mechanical Properties of the Relaxed Biceps and Triceps Brachii Muscles in Patients with Subacute Stroke: A Reliability Study of the Myoton-3 Myometer

Objective. Test-retest reliability of the myotonometer was investigated in patients with subacute stroke. Methods. Twelve patients with substroke (3 to 9 months poststroke) were examined in standardized testing position twice, 60 minutes apart, with the Myoton-3 myometer to measure tone, elasticity, and stiffness of relaxed bilateral biceps and triceps brachii muscles. Intrarater reliability of muscle properties was determined using intraclass correlation coefficient (ICC), the standard error of measurement (SEM), and the minimal detectable change (MDC). Results. Intrarater reliability of muscle properties of bilateral biceps and triceps brachii muscles were good (ICCs = 0.79–0.96) except for unaffected biceps tone (ICC = 0.72). The SEM and MDC of bilateral biceps and triceps brachii muscles indicated small measurement error (SEM% <10%, MDC% <25%). Conclusion. The Myoton-3 myometer is a reliable tool for quantifying muscle tone, elasticity, and stiffness of the biceps and triceps brachii in patients with subacute stroke

Study on River Migration and Stable Water Supply Countermeasure in the Reach of Kaoping Weir

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Dissemination of solar water heaters in South Africa

Global concern over a looming energy crisis, water scarcity and man-made climate change are driving a huge demand for clean technologies, which focus on preserving the earth’s resources. In South Africa, the economy is very energy-intensive with coal being the main national energy supply. In view of the growing depletion of fossil fuel, it is important for South Africa to adopt a more sustainable energy mix. This study examines the potential for widespread dissemination of solar water heaters (SWHs) in South Africa. Barriers and constraints to market expansion are analyzed to determine strategies for overcoming these barriers. It is found that payback period of a SWH is shorter than the life-span of the system itself, indicating that SWHs are economically viable even with low production cost of electricity and thus represent a profitable investment proposition for end users, manufacturers and distributors. However, the subsidy programs offered by the government of South Africa may not be sufficient to facilitate diffusion. This is attributed to the high initial capital cost of the system and low affordability of the majority of the South Africa population with low income. Alternative financing mechanisms are required

Developmental Profiles of Preschool Children With Spastic Diplegic and Quadriplegic Cerebral Palsy

Cerebral palsy (CP) is a disorder of movement and posture control with multiple impairments. The clinical manifestations of CP vary among children. The aim of this study was to compare the developmental profiles of preschool children with either of two types of CP: spastic diplegic (SD) CP and spastic quadriplegic (SQ) CP. Relationships between the children's various developmental functions were also investigated. We recruited 137 children with spastic CP, aged 1-5 years (mean age = 3.7 ± 2.1 years), and we classified them into two groups: SD (n = 59) and SQ (n = 78). The comparison group comprised 18 children with typical development. Developmental functions were assessed in all the children, using the Chinese Child Development Inventory with the updated norms. This scale addressed eight functional domains: gross motor ability, fine motor ability, expressive language ability, concept comprehension ability, situation comprehension ability, self-help ability, personal-social skills, and general development. A development quotient (DQ) was determined for each domain as a percentage of the developmental age divided by the chronological age. The developmental profiles of the CP subtypes were found to differ. Children with SQ were found to have lower DQs than those with SD (p < 0.01). There was also a difference in the distribution of DQs between the SD and SQ groups, although the lowest DQ in both groups was for the gross motor domain. An uneven delay in the development of gross motor function was found in both groups of children with CP. Motor functions, including gross motor and fine motor functions, were significantly related to self-help ability. Complex and significant correlations among developmental functions were also identified in children with CP. The findings in the present study may allow clinicians to anticipate the developmental profile of children with CP on the basis of whether they have the SD or SQ subtype. This, in turn, is likely to facilitate individual assessment, goal setting, and the planning of interventions in children with CP