Responsiveness of the International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis

Background: The comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis (RA) is a selection of 96 categories from the ICF, representing relevant aspects in the functioning of patients with RA. Objectives: To study the responsiveness of the ICF Core Set for RA in rheumatological practice. Methods: A total of 46 patients with RA (72% women, mean (SD) age 53.6 (12.6) years, disease duration 6.3 (8.0) years) were interviewed at baseline and again after 6 months treatment with a disease-modifying antirheumatic drug (DMARD), applying the ICF Core Set for RA with qualifiers for problems on a modified three-point scale (no problem, mild/moderate, severe/complete). Patient-reported outcomes included Modified Health Assessment Questionnaire (MHAQ) and Short-Form 36 (SF-36) health survey, and disease activity was calculated. Responsiveness was measured as change in qualifiers in ICF categories, and was also compared with change in patient-reported outcomes. Results: After 6 months of DMARD treatment, improvement by at least one qualifier was seen in 20% of patients (averaged across all ICF categories), 71% experienced no change and 9% experienced worsening symptoms. Findings were similar across the different aspects of functioning. Mainly moderate effect sizes were seen for 6-month changes in the ICF Core Set for RA, especially in patients with improved health status, with similar effect size for disease activity. The components in the ICF Core Set for RA were only weakly associated with patient-reported outcomes and disease activity. Conclusions: The ICF Core Set for RA demonstrated moderate responsiveness in this real-life setting of patients where minor changes occurred during treatment with DMARDs

Identification of candidate categories of the International Classification of Functioning Disability and Health (ICF) for a Generic ICF Core Set based on regression modelling

Background: The International Classification of Functioning, Disability and Health (ICF) is the framework developed by WHO to describe functioning and disability at both the individual and population levels. While condition-specific ICF Core Sets are useful, a Generic ICF Core Set is needed to describe and compare problems in functioning across health conditions. Methods: The aims of the multi-centre, cross-sectional study presented here were: a) to propose a method to select ICF categories when a large amount of ICF-based data have to be handled, and b) to identify candidate ICF categories for a Generic ICF Core Set by examining their explanatory power in relation to item one of the SF-36. The data were collected from 1039 patients using the ICF checklist, the SF-36 and a Comorbidity Questionnaire. ICF categories to be entered in an initial regression model were selected following systematic steps in accordance with the ICF structure. Based on an initial regression model, additional models were designed by systematically substituting the ICF categories included in it with ICF categories with which they were highly correlated. Results: Fourteen different regression models were performed. The variance the performed models account for ranged from 22.27% to 24.0%. The ICF category that explained the highest amount of variance in all the models was sensation of pain. In total, thirteen candidate ICF categories for a Generic ICF Core Set were proposed. Conclusion: The selection strategy based on the ICF structure and the examination of the best possible alternative models does not provide a final answer about which ICF categories must be considered, but leads to a selection of suitable candidates which needs further consideration and comparison with the results of other selection strategies in developing a Generic ICF Core Set

Experimental ancilla-assisted qubit transmission against correlated noise using quantum parity checking

We report the experimental demonstration of a transmission scheme of photonic qubits over unstabilized optical fibers, which has the plug-and-play feature as well as the ability to transmit any state of a qubit, regardless of whether it is known, unknown, or entangled to other systems. A high fidelity to the noiseless quantum channel was achieved by adding an ancilla photon after the signal photon within the correlation time of the fiber noise and by performing quantum parity checking. Simplicity, maintenance-free feature and robustness against path-length mismatches among the nodes make our scheme suitable for multi-user quantum communication networks.Comment: 8 pages, 4 figures; published in New J. Phys. and selected in IOP Selec

High rate, long-distance quantum key distribution over 250km of ultra low loss fibres

We present a fully automated quantum key distribution prototype running at 625 MHz clock rate. Taking advantage of ultra low loss fibres and low-noise superconducting detectors, we can distribute 6,000 secret bits per second over 100 km and 15 bits per second over 250km

Gene identification for the cblD defect of vitamin B12 metabolism

Background Vitamin B12 (cobalamin) is an essential cofactor in several metabolic pathways. Intracellular conversion of cobalamin to its two coenzymes, adenosylcobalamin in mitochondria and methylcobalamin in the cytoplasm, is necessary for the homeostasis of methylmalonic acid and homocysteine. Nine defects of intracellular cobalamin metabolism have been defined by means of somatic complementation analysis. One of these defects, the cblD defect, can cause isolated methylmalonic aciduria, isolated homocystinuria, or both. Affected persons present with multisystem clinical abnormalities, including developmental, hematologic, neurologic, and metabolic findings. The gene responsible for the cblD defect has not been identified. Methods We studied seven patients with the cblD defect, and skin fibroblasts from each were investigated in cell culture. Microcell-mediated chromosome transfer and refined genetic mapping were used to localize the responsible gene. This gene was transfected into cblD fibroblasts to test for the rescue of adenosylcobalamin and methylcobalamin synthesis. Results The cblD gene was localized to human chromosome 2q23.2, and a candidate gene, designated MMADHC (methylmalonic aciduria, cblD type, and homocystinuria), was identified in this region. Transfection of wild-type MMADHC rescued the cellular phenotype, and the functional importance of mutant alleles was shown by means of transfection with mutant constructs. The predicted MMADHC protein has sequence homology with a bacterial ATP-binding cassette transporter and contains a putative cobalamin binding motif and a putative mitochondrial targeting sequence. Conclusions Mutations in a gene we designated MMADHC are responsible for the cblD defect in vitamin B12 metabolism. Various mutations are associated with each of the three biochemical phenotypes of the disorder

Operationalization and reliability testing of ICF categories relevant for physiotherapists' interventions in the acute hospital

Objective: To operationalize items based on categories of the International Classification of Functioning, Disability and Health (ICF) relevant to patient problems that are addressed by physiotherapeutic interventions in the acute hospital, and to test the reliability of these items when applied by physiotherapists. Methods: A selection of 124 ICF categories was operationalized in a formal decision-making and consensus process. The reliability of the newly operationalized item list was tested with a cross-sectional study with repeated measurements. Results: The item writing process resulted in 94 dichotomous and 30 polytomous items. Data were collected in a convenience sample of 28 patients with neurological, musculoskeletal, cardiopulmonary, or internal organ conditions, requiring physical therapy in an acute hospital. Fifty-six percent of the polytomous and 68% of the dichotomous items had a raw agreement of 0.7 or above, whereas 36% of all polytomous and 34% of all dichotomous items had a kappa coefficient of 0.7 and above. Conclusion: The study supports that the ICF is adaptable to professional and setting-specific needs of physiotherapists. Further research towards the development of reliable instruments for physiotherapists based on the ICF seems justified. Key words: ICF; classification; reliability; outcome measures; health status assessment

Developing core sets for persons following amputation based on the International Classification of Functioning, Disability and Health as a way to specify functioning

Amputation is a common late stage sequel of peripheral vascular disease and diabetes or a sequel of accidental trauma, civil unrest and landmines. The functional impairments affect many facets of life including but not limited to: Mobility; activities of daily living; body image and sexuality. Classification, measurement and comparison of the consequences of amputations has been impeded by the limited availability of internationally, multiculturally standardized instruments in the amputee setting. The introduction of the International Classification of Functioning, Disability and Health (ICF) by the World Health Assembly in May 2001 provides a globally accepted framework and classification system to describe, assess and compare function and disability. In order to facilitate the use of the ICF in everyday clinical practice and research, ICF core sets have been developed that focus on specific aspects of function typically associated with a particular disability. The objective of this paper is to outline the development process for the ICF core sets for persons following amputation. The ICF core sets are designed to translate the benefits of the ICF into clinical routine. The ICF core sets will be defined at a Consensus conference which will integrate evidence from preparatory studies, namely: (a) a systematic literature review regarding the outcome measures of clinical trails and observational studies, (b) semi-structured patient interviews, (c) international experts participating in an internet-based survey, and (d) cross-sectional, multi-center studies for clinical applicability. To validate the ICF core sets field-testing will follow. Invitation for participation: The development of ICF Core Sets is an inclusive and open process. Anyone who wishes to actively participate in this process is invited to do so

Listening with style: The effect of bidialectal style-shifting on PRICE vowel perception in Britain’s Black Country

Speech perception research has found that manipulating listener attitudes towards a dialect area can lead to convergence or divergence in production style, as well as a simultaneous convergence or divergence in perception. The present study investigates whether these two effects are connected, such that the changes in production style are the cause of changes in perception. The potential link is interrogated directly through an experiment which pushes participants’ stylistic production towards the extreme ends of their repertoires, followed by a perceptual test in which they match vowel tokens to a vowel line-up resynthesized along the same standard- dialect continuum. Analysis of the data shows that style does affect perception: as participants are asked to switch from a more standard to a more dialectal style, their perceptual categories shift towards the standard end of the vowel continuum, i.e., when they speak in dialect, vowels are more likely to be rated as standard-sounding, and vice-versa

Habitat requirements and ecological niche of two cryptic amphipod species at landscape and local scales

Cryptic species are phylogenetically diverged taxa that are morphologically indistinguishable and may differ in their ecological and behavioral requirements. This may have important implications for ecosystem services and conservation of biodiversity. We investigated whether two ecologically important cryptic species of the freshwater amphipod Gammarus fossarum (types A and B) are associated with different habitats. We collected data on their occurrence at both the landscape scale (large watersheds) and at the local scale (river reach) to compare macro- and microscale environmental parameters associated with their presence. Analysis of the landscape scale data showed that occurrence of types A and B differ with respect to watershed and river size and, interestingly, human impact on river ecomorphology. Whereas type B was mainly found in less forested areas with higher human impact, type A showed the opposite occurrence pattern. Analyses of the local scale data suggested that habitats occupied by type A were characterized by larger gravel, larger stones and less macrophytes than habitats occupied by type B. The landscape and local data set showed contradicting patterns with regard to stream size. Overall, the observed differences between the two types of G. fossarum most likely reflect ecological differences between them, but alternative explanations (e.g., historical colonization processes) cannot be completely ruled out. Our study underlines that common cryptic species can differ in their ecology and response to anthropogenic influence. Such differences in habitat requirements among difficult-to-identify taxa present a challenge for biodiversity and ecosystem management. Our results emphasize the importance of conservative and precautionary approaches in maintenance of habitat diversity and environmental heterogeneity

Capturing patients’ needs in casemix: a systematic literature review on the value of adding functioning information in reimbursement systems

STROBE. (PDF 28 kb