Rare diseases: matching wheelchair users with rare metabolic, neuromuscular or neurological disorders to electric powered indoor/outdoor wheelchairs (EPIOCs)

Purpose: To describe the clinical features of electric powered indoor/outdoor wheelchair (EPIOC) users with rare diseases (RD) impacting on EPIOC provision and seating. Method: Retrospective review by a consultant in rehabilitation medicine of electronic and case note records of EPIOC recipients with RDs attending a specialist wheelchair service between June 2007 and September 2008. Data were systematically extracted, entered into a database and analysed under three themes; demographic, diagnostic/clinical (including comorbidity and associated clinical features (ACFs) of the illness/disability) and wheelchair factors. Results: Fifty-four (27 male) EPIOC users, mean age 37.3 (SD 18.6, range 11–70) with RDs were identified and reviewed a mean of 64 (range 0–131) months after receiving their wheelchair. Diagnoses included 27 types of RDs including Friedreich’s ataxia, motor neurone disease, osteogenesis imperfecta, arthrogryposis, cerebellar syndromes and others. Nineteen users had between them 36 comorbidities and 30 users had 44 ACFs likely to influence the prescription. Tilt-in-space was provided to 34 (63%) users and specialised seating to 17 (31%). Four users had between them complex control or interfacing issues. Conclusions: The complex and diverse clinical problems of those with RDs present unique challenges to the multiprofessional wheelchair team to maintain successful independent mobility and community living

Out of court Alternatives for drunkeness offenders: dealing with drunkeness: a proposal for change

SIGLELD:f82/3368 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Survey Lifestyle of long term psychiatric patients in the London Borough of Hackney

SIGLELD:f83/2186 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Survey of the mobility of disabled people in a rural environment

SIGLELD:f83/2319 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Employers guide to disabilities

SIGLELD:82/19034(Employers). / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Putting teeth in the act A history of attempts to enforce the provisions of section 2 of the Chronically Sick and Disabled Persons Act 1970

LD:f83/1890 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Motoring and mobility for disabled people

0.75LD:82/21828(Motoring) / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Local authority provision of housing services for disabled people A report to RADAR's Housing Committee on recent research

SIGLELD:f84/1927 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Obese patients' characteristics and weight loss outcomes in cardiac rehabilitation : An observational study of registry data

AIM: Cardiac rehabilitation (CR) guidelines advocate weight loss for obese patients but mean weight loss is small. We sought to determine the extent to which obese patients' characteristics prior to CR predict weight loss. METHODS: An observational, pre- and post CR study of routine practice using the UK National Audit of Cardiac Rehabilitation dataset was undertaken. Backward, stepwise, multiple linear regression analysis was used to identify characteristics prior to CR that predicted weight change in obese patients. RESULTS: In 29,601 obese patients undertaking CR, mean weight loss was 0.9 kg (SD 4.3; p < 0.001) in men (74% of sample) and 0.5 kg (SD 3.9; p < 0.001) in women. Smoking cessation since the cardiac event independently predicted less weight loss by 1.2 kg (95% CI; 0.9, 1.5 kg; p < 0.001). Diabetes, cardiac surgery, living in a deprived area, being female, low fitness levels and pain independently predicted less weight loss during CR. Higher initial weight, greater age and being employed predicted increased weight loss. CONCLUSION: This is the first study to identify how the characteristics of obese patients independently predict different amounts of weight loss during CR in free-living individuals. It is also the largest, registry-based study to investigate predictors of weight loss in obese patients in CR. Knowledge of the extent to which obese patients' characteristics predict more or less weight loss can aid: the generation of guidelines; agreement of realistic goals with patients; and tailoring of weight management support