Adding a subjective dimension to an ICF-based disability measure for people with multiple sclerosis: development and use of a measure for perception of disabilities

OBJECTIVE: The subjective dimension of disability, the perception of disability, is a dimension missing from the International Classification of Functioning, Disability and Health (ICF), and from health-related quality of life (HRQOL) instruments. However, it is a highly relevant dimension for clinical practice as perceived disability may identify care needs. We therefore developed a measure for this subjective dimension of disability in multiple sclerosis (MS) and examined the contribution of this dimension to QOL. METHOD: A measure named the Multiple Sclerosis Impact Profile-Disability Perception (MSIP-DP) was developed to reflect a person's perception of disabilities reported using the original MSIP-disability (MSIP-D) items. MS patients (n=530) completed both MSIP sections, the medical outcome study short form questionnaire (SF-36), the World Health Organisation Quality Of Life-BREF (WHOQOL-BREF) and questions concerning disease severity. The contribution of disability perception (DP) to QOL in MS was estimated using hierarchical multiple regression analyses after controlling for MS severity. RESULTS: Confirmative factor analysis confirmed the hypothesised disability perception domains that correspond with the related disability domains in the MSIP. DP scales yielded sufficient reliability. DP explained a unique and substantial part of the variance in QOL, particularly the perception of impairments in mental functions. DISCUSSION: Results indicated that the subjective dimension of functioning and health operationalised in the MSIP-DP is a relevant concept in explaining QOL in MS. In clinical practice psychological interventions addressing a patient's perception of disability, particularly of impairments in mental functioning, may contribute to QOL

High Aspect Pattern Formation by Integration of Micro Inkjetting and Electroless Plating

This paper reports on formation of high aspect micro patterns on low temperature co-fired ceramic (LTCC) substrates by integrating micro inkjetting with electroless plating. Micro inkjetting was realized by using an inkjetting printer that ejects ink droplets from a printhead. This printhead consists of a glass nozzle with a diameter of 50 micrometers and a piezoelectric transducer that is coated on the nozzle. The silver colloidal solution was inkjetted on a sintered CT800 ceramic substrate, followed by curing at 200 degrees C for 60 minutes. As a result, the silver trace with a thickness of 200 nm was obtained. The substrate, with the ejected silver thin film as the seed layer, was then immersed into a preinitiator solution to coat a layer of palladium for enhancing the deposition of nickel. Electroless nickel plating was successfully conducted at a rate of 0.39 micrometers /min, and the thickness of traces was plated up to 84 micrometers. This study demonstrates that the integration of inkjetting with plating is an effective method to form high aspect patterns at the demand location.Comment: Submitted on behalf of EDA Publishing Association (http://irevues.inist.fr/handle/2042/16838

Broadening the scope on health problems among the chronically neurologically ill with the International Classification of Functioning (ICF)

Purpose. The aim of this study was to determine ICF items indicating health problems for patients with a chronic neurological disorder such as multiple sclerosis, Parkinson's disease and neuromuscular disease. Method. A Delphi study using three disease-specific panels composed of patients and proxies, medical and non-medical health professionals (N=98). Panels were asked to select items from the International Classification of Functioning, Disability and Health (ICF) reflecting relevant disease-specific health problems. Items appraised as relevant by the panel members were compared with items in established measures namely: the Minimal Record of Disability (MRD) and the Disability and Impact Profile (DIP). Results. Sixty-eight ICF items were considered to be the most relevant, and belonged to four ICF domains. No significant differences were found between the appraisal of items by patients/proxies and health professionals. Agreement across the disease panels appeared to be (very) strong. Differences between the three disease-specific panels were found for the 'Body Functions and Structures' domain: consensus was reached by extension of the inclusion criteria. The ICF-item selection covers almost all items of the established measures. The largest contrast was shown in the item selection for the 'participation' and 'environmental factors' domains. Conclusions. Selected items indicate a broader scope in studying health problems compared with widely used health status measures in neurology, especially for the ICF domains 'Participation' and 'Environmental Factors'

Tunneling Via Individual Electronic States in Ferromagnetic Nanoparticles

We measure electron tunneling via discrete energy levels in ferromagnetic cobalt particles less than 4 nm in diameter, using non-magnetic electrodes. Due to magnetic anisotropy, the energy of each tunneling resonance shifts as an applied magnetic field rotates the particle's magnetic moment. We see both spin-increasing and decreasing tunneling transitions, but we do not observe the spin degeneracy at small magnetic fields seen previously in non-magnetic materials. The tunneling spectrum is denser than predicted for independent electrons, possibly due to spin-wave excitations.Comment: 4 pages, 4 figures. Improved by comments from referees, to appear in Phys. Rev. Let

Economic transition and elections in Poland 1

Poland's economic and political transition, one of the most successful, has depended very heavily on job creation in new firms to replace the jobs lost in the formerly state-owned enterprises. This paper uses survey and aggregate data from three Polish elections to suggest that these de novo firms, the individuals they employ, and the residents in the local areas where they exist become an important constituency supporting pro-reform political parties and constraining the actions of parties less sympathetic to the reforms. The creation of this political constituency helps explain how countries can successfully pursue both economic and political reforms. JEL classification: D72, P26.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72227/1/1468-0351.00139.pd

Physical conditions of fast glacier flow:3. Seasonally-evolving ice deformation on Store Glacier, West Greenland

Temporal variations in ice sheet flow directly impact the internal structure within ice sheets through englacial deformation. Large‐scale changes in the vertical stratigraphy within ice sheets have been previously conducted on centennial to millennial timescales; however, intra‐annual changes in the morphology of internal layers have yet to be explored. Over a period of 2 years, we use autonomous phase‐sensitive radio‐echo sounding to track the daily displacement of internal layers on Store Glacier, West Greenland, to millimeter accuracy. At a site located ∼30 km from the calving terminus, where the ice is ∼600 m thick and flows at ∼700 m/a, we measure distinct seasonal variations in vertical velocities and vertical strain rates over a 2‐year period. Prior to the melt season (March–June), we observe increasingly nonlinear englacial deformation with negative vertical strain rates (i.e., strain thinning) in the upper half of the ice column of approximately −0.03 a⁻¹, whereas the ice below thickens under vertical strain reaching up to +0.16 a⁻¹. Early in the melt season (June–July), vertical thinning gradually ceases as the glacier increasingly thickens. During late summer to midwinter (August–February), vertical thickening occurs linearly throughout the entire ice column, with strain rates averaging 0.016 a⁻¹. We show that these complex variations are unrelated to topographic setting and localized basal slip and hypothesize that this seasonality is driven by far‐field perturbations in the glacier's force balance, in this case generated by variations in basal hydrology near the glacier's terminus and propagated tens of kilometers upstream through transient basal lubrication longitudinal coupling