Predictors of needs for community and financial resources for families of pre-school children with cerebral palsy

An understanding of predictors of family needs for the families of preschool children with cerebral palsy (CP) is important for provision of efficient and cost-effective services. The aim of this study was to identify the characteristics of children, families and services that are risk factors to meeting family needs for community and financial resources. 234 parents of pre-school children with CP completed a modified version of the Family Needs Survey (FNS), the Measure of Processes of Care (MPOC-20), and a demographic questionnaire. The gross motor function level and communication function level of children were classified on the basis of the Gross Motor Function Classification System (GMFCS) and the Communication Function Classification System (CFCS) respectively. Two hierarchical multiple regression models were generated to determine the predictors of unmet family needs. The socialisation and communication skills of children, as well as caregiver employment and family income levels were significant predictors of family needs for community resources (adjusted R2=0.44). Significant risk factors in terms of family needs for financial resources included the child's gross motor limitations, caregiver employment, low levels of family income and no ability to receive services on the basis of enabling and partnership principles (adjusted R2=0.51). A child's limitations in terms of communication, gross motor functions and socialisation, as well as the socioeconomic status of the child's family, must be taken into account when planning services for families with preschool children with CP.publishersversionPeer reviewe

The World Health Organisation Disability Assessment Scale (WHODAS II): Links between self-rated health and objectively defined and clinical parameters in the population of spinal cord injury

There are many clinical and objectively defined parameters that are used to evaluate a person's disability. Since the World Health Organisation has presented the WHODAS II as a means of objectively measuring subjectively defined functions, greater attention has been focused on self-rated health. Only a few studies, however, have been conducted about differences between self-rated health and objectively defined parameters. The survey for this study was conducted on the basis of WHODAS II and the population in Latvia with spinal cord injury. Respondents were between 18 and 65, and 98 questionnaires were analysed. The results show that people with spinal cord injury on average rate their functioning as limited (33–40 points of 100). Most respondents have been declared to be disabled, which is defined as very serious or severe functional disorders. More than 40% have paid jobs, while one-third do not work for reasons of health. The research shows that there is a close coherence (p< 0.05) between individual, objectively and clinically defined indicators on the one hand and the aspects of the questionnaire in which physical functioning was an important factor on the other hand. In order to understand the real functional abilities of patients and the individual factors that influence those abilities, it is necessary to define functional self-rated health in addition to objectively defined indicators.publishersversionPeer reviewe

CHANGES OF THE PENETRATION STRENGTH OF THE LUMBAR VERTEBRAE TRABECULAR BONE OF ATHLETES DURING TRAINING

INTRODUCTION: Great static and dynamic load during athletic trainings with weightlifting exercises influence the skeleton, especially spine, of athletes. Some athletes feel pain in lumbar region during such athletic training. Changes in vertebrae bone tissue are mentioned as one of the reasons for pain (1). The osteopenetromethry method has been used for the evaluation of vertebra trabecular bone during the previous years (2,3). The purpose of this study was to examine the changes of vertebra penetration strength (PS) in lumbar region of athletes during the athletic training with weight-lifting exercises using this method. METHODS:120 athletes (aged 18 to 26) from different sports (Tab.1) were examined. We examined PS of 3 to 5 lumbar vertebrae on the 1st, 7th, 14th, 21st and 28th day of athletic training, according to the method described by Logins (3). RESULTS:The PS of lumbar vertebrae of the athlets on the 1st training day was from 4.2 MPa up to 5.1 MPa. On the 7th day of training the decrease from 17% to 35% of the initial value of PS was denoted. According to the level of PS decrease, we conditionally divided the athlets into two groups. The PS of the first group athlets was decreased for 20% of the initial value. The PS decrease of the second group of athlets exceeded 20% of the initial value (Tab.2) [Tab.2.] On the 14th day of athletic training’s the rehabilitation of the initial level of PS of lumbar vertebrae was denoted for the first group athletes and stayed the same during all the time of intensive load (28 days). For the second group of athletes during the time of intensive load the decrease of PS of lumbar vertebrae was denoted up to 2.7±0.38 MPa on the 28th day of athletic training. CONCLUSIONS: The results of our investigation prove that intensive physical load during athletic training’s with weight-lifting exercise of athletes causes changes to the structural organization of vertebral trabecular bone and bone mineral content. If the load exceeds the functional possibilities of spine, the remarkable changes of the vertebral trabecular bone strength take place in 7th day of training. REFERENCE: 1. Silva MJ.Gibson JA.(1997) Bone 21(2):191-199. 2. Hvid I. (1988) Clin Orthop.227: 210-221. 3. Logins V (1996) Mechanics of Composit.Materials 4:564-573

Quality of life and provision of social rehabilitation services in elementary school age children with special needs in Riga City

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Screening of patients for first time prostheses after amputation of lower limbs

In the world's developed countries, demographic changes, such as aging societies and increased numbers of diabetes patients, have led to an increase in amputations (11), and it is believed that as society ages, the number of people who are older than 65 will face as much as two times more amputations [3]. Of great importance after the amputation of a lower limb is the selection and adaptation of prostheses that allow patients to move around, thus achieving rehabilitation goals much more quickly [5]. A 20090-study of the rehabilitation of people with lower limb amputations in Latvia found that among 183 patients, 50% use their prostheses actively for more than 6 hours a day, 30% did not use them at all or used them for less than 3 hours a day, and 20% used them for 3-6 hours a day. The study included 173 patients with lower limb amputations who were evaluated in 2012 in relation with whether primary prosthesis should be provided. Of 173 patients who were evaluated, only 109 received a decision on primary prostheses, while in 51 cases the process was delayed for 1–3 months, in 12 cases, it was decided that prostheses would not be purposeful. More than 25% of those who followed the recommended treatment and rehabilitation programme to prepare the amputation stump, reduced contracture and enhanced physical working abilities were declared to be appropriate for further prostheses. This indicates serious shortcomings in medical treatments during the early post-amputation period.publishersversionPeer reviewe

The Unified Method: I Non-Linearizable Problems on the Half-Line

Boundary value problems for integrable nonlinear evolution PDEs formulated on the half-line can be analyzed by the unified method introduced by one of the authors and used extensively in the literature. The implementation of this general method to this particular class of problems yields the solution in terms of the unique solution of a matrix Riemann-Hilbert problem formulated in the complex $k$-plane (the Fourier plane), which has a jump matrix with explicit $(x,t)$-dependence involving four scalar functions of $k$, called spectral functions. Two of these functions depend on the initial data, whereas the other two depend on all boundary values. The most difficult step of the new method is the characterization of the latter two spectral functions in terms of the given initial and boundary data, i.e. the elimination of the unknown boundary values. For certain boundary conditions, called linearizable, this can be achieved simply using algebraic manipulations. Here, we present an effective characterization of the spectral functions in terms of the given initial and boundary data for the general case of non-linearizable boundary conditions. This characterization is based on the analysis of the so-called global relation, on the analysis of the equations obtained from the global relation via certain transformations leaving the dispersion relation of the associated linearized PDE invariant, and on the computation of the large $k$ asymptotics of the eigenfunctions defining the relevant spectral functions.Comment: 39 page

Balance conditions in variational data assimilation for a high-resolution forecast model

This paper explores the role of balance relationships for background error covariance modelling as the model's grid box decreases to convective-scales. Data assimilation (DA) analyses are examined from a simplified convective-scale model and DA system (called ABC-DA) with a grid box size of 1.5km in a 2D 540km (longitude), 15km (height) domain. The DA experiments are performed with background error covariance matrices B modelled and calibrated by switching on/off linear balance (LB) and hydrostatic balance (HB), and by observing a subset of the ABC variables, namely v, meridional wind, r', scaled density (a pressure-like variable), and b', buoyancy (a temperature-like variable). Calibration data are sourced from two methods of generating proxies of forecast errors. One uses forecasts from different latitude slices of a 3D parent model (here called the `latitude slice method'), and the other uses sets of differences between forecasts of different lengths but valid at the same time (the National Meteorological Center method). Root-mean-squared errors computed over the domain from identical twin DA experiments suggest that there is no combination of LB/HB switches that give the best analysis for all model quantities. It is frequently found though that the B-matrices modelled with both LB and HB do perform the best. A clearer picture emerges when the errors are examined at different spatial scales. In particular it is shown that switching on HB in B mostly has a neutral/positive effect on the DA accuracy at `large' scales, and switching off the HB has a neutral/positive effect at `small' scales. The division between `large' and `small' scales is between 10 and 100km. Furthermore, one hour forecast error correlations computed between control parameters find that correlations are small at large scales when balances are enforced, and at small scales when balances are not enforced (ideal control parameters have zero cross correlations). This points the way to modelling B with scale-dependent balances

Physiotherapy following cardiac surgery: Program comparison

The objective is to examine and compare the usability of two physiotherapy programmes, analyzing respiratory function in patients before and after cardiac surgery in hospital during seven postoperative days (POD). Quantitative randomized prospective study of 157 patients before and after the valve replacement surgery, coronary artery bypass graft and combined surgeries, who moved independently. Participants were randomized into two groups (1 and 2) with different physiotherapy programmes. The routine physiotherapy of breath-enhancing techniques, micro-circulation improvement were used for the first group, for the second group - modified physiotherapy – the improvement of inspiration muscles, mm. quadriceps. gluteus max strength. Anthropometric measurements were defined for both groups on the day before surgery and during spirography - dynamic indicators - forced vital capacity (FVC), forced expiratory volume in the 2nd second (FEV1), Tiffeneau index (FEV1 / VC (%)), peak expiratory flow (PEF), operation parameters. By comparing the postoperative respiratory parameters between the two groups and using independent samples t test, it was found out that the difference in FVC between groups is 1.71 [95% CI: −8.25 to 4.8] and it is not statistically significant (t (155) = −0.52; p = 0.60). Based on the Leuven test results FVC the distribution variance is not statistically notably different for group 1 and group 2 (F = 0.27, p=0.60). Using routine and modified physiotherapy and comparing postoperative dynamic respiratory performance of the two groups, there was no statistically significant difference, proving that the two models are equally effective

The consequences of shoulder pain intensity on quality of life and community participation in paraplegic wheelchair users

Background/Objectiv