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'

Social support as a predictor of perceived health status in patients with multiple sclerosis

Objective: The main aim of this study was to investigate whether different levels of perceived social support are associated with different levels of perceived health status in multiple sclerosis (MS) patients. Methods: Two hundred and seven MS patients (38.4 +/- 10.6 years, 66.2% female) completed the Short-Form-36 Health Survey (SF-36) as the measure for perceived health status, and the perceived social support scale (PSSS) as the measure for social support. Functional disability was assessed using Kurtzke's expanded disability status scale (EDSS). The contribution of EDSS and PSSS for explaining the variance in SF-36 was investigated with multiple linear regression analysis. Results: Demographic variables and EDSS explained 44% of the variance of the physical health summary scale in the SF-36. Demographic variables, EDSS and PSSS front family and friends explained 24% of the variance in mental health summary scale in the SF-36. Results varied according to the multiple linear regression analyses of predictors of variance in the eight dimensions of the SF-36. Conclusion: PSSS from significant others was positively associated with general health dimension of perceived physical health status, while PSSS from family and friends was positively associated with perceived mental health status in MS patients. Practice implications: The results show the importance of supporting social ties and relationships between MS patients and others. (C) 2008 Elsevier Ireland Ltd. All rights reserved

The impact of the intensity of fear on patient’s delay regarding health care seeking behavior: a systematic review

This systematic review focuses on the role of the intensity of fear in patient's delay in cancer and in myocardial infarction. In a search of literature published between 1990 and June 2009, 161 articles were found. After the use of inclusion and exclusion criteria, 11 articles in cancer and 4 articles in myocardial infarction remained. High levels of fear are associated with earlier help-seeking in both diseases; for low levels of fear, the picture is unclear. The level of fear is an important factor, which should be taken into account when facilitating help-seeking by patients

SYNTHESIS AND CYTOTOXICITY OF NOVEL LIGNANS

In this study the syntheses of 11 novel lignans are described. Their cytotoxicities are studied in GLC4, a human small cell lung carcinoma cell line, using the microculture tetrazolium (MTT) assay. Ten of these compounds were substituted with a menthyloxy group on the 5-position of the lactone. These compounds can easily be prepared in (novel) ‘one-pot’, three- or four-step syntheses. In addition, methods for controlling the stereogenic centers are described. Furthermore, five naturally occurring podophyllotoxin-related compounds were tested. The cytotoxicities of all lignan compounds, and of three non-lignan intermediates originating from the syntheses, were compared with the clinically applied anticancer agents etoposide, teniposide, and cisplatin. Most compounds showed moderate to high activities against GLC4, and two of the compounds containing a menthyloxy group showed activities comparable to the reference cytotoxic agents.

Ferritic stainless steel welding with the A-TIG process

O processo de soldagem TIG com fluxo (processo A-TIG) apresenta como principal vantagem a possibilidade de se obter uma maior penetração do cordão de solda empregando os mesmos parâmetros de soldagem do processo TIG convencional. Diversos estudos mostram a influência dos fluxos ativos sobre as características geométricas das soldas em aços inoxidáveis austeníticos, porém pouco se sabe sobre a influência deste processo nas características geométricas e metalúrgicas de cordões de solda em aços inoxidáveis ferríticos. Neste trabalho são aplicados diferentes tipos de fluxo na soldagem de aço inoxidável ferrítico com o objetivo de verificar possíveis influências no perfil do cordão de solda, no seu aspecto visual, na microestrutura, na dureza da zona fundida e na resistência ao impacto (ensaio Charpy). As soldagens "bead-on-plate" foram realizadas sem metal de adição. Foram utilizados seis tipos de fluxo, sendo um óxido elaborado em laboratório (TiO2) e cinco fluxos comerciais. Os resultados mostraram que a utilização do fluxo permite um aumento na penetração com mudanças significativas no aspecto do cordão de solda. Verificou-se ainda que a microestrutura e a dureza do cordão de solda do aço estudado não foram afetadas pelo tipo de fluxo utilizado, com a microestrutura analisada em microscópio óptico. O aço em estudo mostrou um alto grau de fragilidade à temperatura ambiente._________________________________________________________________________________________ RESUMO: The A-TIG welding process presents as main advantage the possibility of increase in the penetration depth using the same parameters as conventional TIG welding. Many researchers show the influence of the active flux on the weld geometry in austenitic stainless steel, however little it is known of the influence of this process in the weld fillet shape and metallurgic characteristics of the weld fillet in ferritic stainless steel. In this work different types of flux are applied with the objective to verify possible influences on the weld fillet in ferritic stainless steel welding, such its visual aspect, the microstructure, the hardness and resistance to the impact of the fusion zone. Bead on plate welds were made without metal filler. Six types of flux had been used, and one flux was prepared in laboratory (TiO2) and the others five were commercial flux. The results indicate that the use of the flux allows increase in the penetration with significant changes in the aspect of the weld fillet. It was verified that the microstructure and the hardness of the weld fillet of this ferritic stainless steel was not been affected by the flux type. The result of the Charpy test in the metal base it was batter in the fusion zone