Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome

Background: Cold sensitivity is a common and disabling complaint following hand injuries. The main purpose of this study was to describe self-reported consequences of cold sensitivity and the association with disability and health-related quality of life in patients with hand injuries or hand-arm vibration syndrome (HAVS) and in normal subjects. Methods: Responses to the Cold Intolerance Symptom Severity (CISS) questionnaire, Potential Work Exposure Scale (PWES), Disability of the Arm, Shoulder and Hand (DASH) and Short-Form 36 questionnaire (SF-36) were investigated in normal subjects (n = 94), hand injured patients (amputation and nerve injuries, n = 88) and patients with HAVS (n = 30). The results are presented as median (range), percent and mean deviation from norms. The Kruskal Wallis Test or Mann-Whitney U-Test were used to identify significant differences between multiple groups or subgroups. The Spearman rank correlation was used to study the relationship between cold sensitivity and disability. Results: Abnormal cold sensitivity (CISS score > 50) was seen in 75% and 45% of patients with HAVS and a traumatic hand injury, respectively. Patients were significantly more exposed to cold in their work environment than the normal population, with a consequently negative effect on work ability due to cold sensitivity. Patients with abnormal cold sensitivity were more seriously disabled and had a poorer health-related quality of life than patients with normal cold sensitivity [higher DASH scores and e. g. significantly larger mean deviation from norms in the subscales Role Physical and Bodily Pain (SF-36)]. Conclusion: Severe and abnormal cold sensitivity may have a profound impact on work capacity, leisure, disability and health-related quality of life. It is frequently seen in patients with traumatic hand injuries and particularly apparent in patients with HAVS

Bedömnings-, dokumentationspraktiker och pedagogiska identiteter

When competition and an increasing level of marketisation characterises school life, the number of evaluations and the level of control has grown out of proportion. Through comparisons, assessments and ranking systems, also called ‘the terrors of performativity’ according to Ball (2003) commercial agents have gained influence over practices of assessment and documentation within the education system. Increased demands on pupils’ and parents’ participation and a belief that written documentation will lead to better results has caused an extensive use of different web based tools like Unikum. With the point of departure in a collected material of more than a hundred Individual Educations Plans (IEP) where commercial web based tools have been used, we make an analysis with Basil Bernstein’s (1996, 2000) concepts Pedagogic Identity, and Instructional and Regulative discourse in relation to expectations and constructions manifest in the plans. The results show that all four identities are expressed in the plans however, with an emphasis on a neo-liberal identity. We discuss the results in relation to the instructional and regulative discourses. The conclusion is that the tools both shape and determine possible identities and possible discourses in the web based interaction between children, parents and teachers

An instrument for measuring health-related quality of life in patients with Deep Venous Thrombosis (DVT): development and validation of Deep Venous Thrombosis Quality of Life (DVTQOL) questionnaire

BACKGROUND: Few studies have evaluated patient-reported outcomes in connection with a primary event of deep venous thrombosis, partly due to a lack of disease-specific measures. The aim here was to develop a disease-specific health-related quality of life (HRQL) measure, the deep venous thrombosis quality of life questionnaire (DVTQOL), for patients with recent exposition and treatment of proximal deep venous thrombosis. METHODS: A total of 121 consecutive outpatients (50 % males; mean age 61.2 ± 14 years) treated with warfarin (Waran(®)) for symptomatic proximal deep venous thrombosis were included in the study. Patients completed the SF-36, EQ-5D and the pilot version of the DVTQOL. RESULTS: Items having: high ceiling and floor effect, items with lower factor loadings than 0.50 and items loading in several factors were removed from the pilot version of DVTQOL. In addition, overlapping and redundant items identified by the Rasch analysis were excluded. The final DVTQOL questionnaire consists of 29 items composing six dimensions depicting problems with: emotional distress; symptoms (e.g. pain, swollen ankles, cramp, bruising); limitation in physical activity; hassle with coagulation monitoring; sleep disturbance; and dietary problems. The internal consistency reliability was high (alpha value ranged from 0.79 to 0.93). The relevant domains of the SF-36 and EQ-5D significantly correlated with DVTQOL, thereby confirming its construct validity. CONCLUSIONS: The DVTQOL is a short and user-friendly instrument with good reliability and validity. Its test-retest reliability and responsiveness to change in clinical trials, however, must be explored

Psychometric validation of the German translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in patients with reflux disease

BACKGROUND: Symptoms of heartburn has an impact on health-related quality of life (HRQL). When a questionnaire is translated into a new language, a linguistic validation is necessary but not sufficient unless the psychometric characteristics have been verified. The aim is to document the psychometric characteristics of the German translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire. METHODS: 142 patients with symptoms of heartburn (Age: M = 47.5, ± 14.6; Males = 44.4%) completed the German translation of GSRS, the QOLRAD, the Short-Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. RESULTS: The internal consistency reliability of GSRS ranged from 0.53–0.91 and of QOLRAD from 0.90–0.94, respectively. The test-retest reliability of GSRS ranged from 0.49–0.73 and of QOLRAD from 0.70–0.84. The relevant domains of the GSRS and QOLRAD domain scores significantly correlated. GSRS domains of Abdominal Pain and Constipation correlated (negatively) with most of the domains of the SF-36. The relevant QOLRAD domains significantly correlated with all SF-36 domains. CONCLUSIONS: The psychometric characteristics of the German translation of GSRS and QOLRAD were found to be good, with satisfactory reliability and validity. The reliability of the GSRS Abdominal Pain domain was moderate

Reliability and validity of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in dyspepsia: A six-country study

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The Fourteenth Amendment, the “Right” to Vote, and the Understanding of the Thirty-Ninth Congress

If that history does not prove what I think it does, we are at least entitled to be told why

Mini Review on the Use of Clinical Cancer Registers for Prostate Cancer: The National Prostate Cancer Register (NPCR) of Sweden

Given the increasing prevalence of cancer, it is vital to systematically collect data in order to monitor disease trends and quality of cancer care. For this purpose, clinical cancer registries have been developed in some countries. These registers are intended to be used as a basis for quality assurance and quality improvement, but they also constitute a rich resource of real world data for research. The aim of this mini-review was to describe the structure and the organization of the National Prostate Cancer Register (NPCR) with some examples on how data in NPCR have affected prostate cancer care in Sweden

Cold Sensitivity in injured and normal hands. Consequences for daily life

Cold sensitivity is a common and persistent complaint after various hand injuries and diseases. The general aim of the thesis was to investigate the consequences of cold sensitivity for daily life in patients with traumatic hand injuries and hand-arm vibration syndrome (HAVS). To obtain a richer and more comprehensive picture reflecting the aim, studies with a quantitative and a qualitative design were performed. Questionnaires comprising patients’ experience of cold sensitivity were translated into Swedish according to the cross-cultural adaptation process and content and construct validity, internal consistency and test-retest reliability were established. In addition, a cut-off for abnormal cold sensitivity was defined as a total score > 50 on the Cold Intolerance Symptom Severity (CISS) questionnaire based on a normal population. Patients with abnormal self-reported cold sensitivity were more seriously disabled and had a poorer health-related quality of life than patients with normal cold sensitivity. The engagement in occupations was limited because of cold induced symptoms despite access to relieving strategies. The consequences and adaptation in daily life meant a change of occupational patterns and performance, a struggle with self-image and a change in life roles. Factors associated with abnormal cold sensitivity after a hand injury were a larger number of repaired vessels and use of vascular grafts at reconstruction, presence of trauma to bones and a high HISS score, suggesting multifactorial causes of cold sensitivity. Behavioural treatment offered relief to a majority of patients with a traumatic hand injury in contrast to patients with HAVS. Patients with HAVS had in comparison to hand injured patients overall significantly more severe problems with cold sensitivity

Från Frost till Skylanders : Hur bemöter vi barnens intressen inom förskolans verksamhet?

In my essay, I explore the dilemma how I respond to the various hobbies that children carry with them to preschool. I want to be able to allow every child to take part of their hobbies at preschool, but I still get stuck in accepting some hobbies, while I deny others. In my stories, I focus on two situations where I have a hard time accepting the children's hobbies, because I think they interfer with preschool routine. Through my questions, I then go on to examine why I react like this, and how I could act differently towards these children. My method is to write a scientific essay, where I explore my own experience through writing, and reflect on my dilemma by looking at it from different angles. I set out from a hermeneutic perspective, where Hans-George Gadamer's theories on preconceptions and the horizon of understanding form a base for my reflections. I've chosen to explore two different approaches that I could take in my response towards the children. One is based on Gert Biesta's thoughts on a pedagogy of interruption, which is about interrupting the children in what they are doing, to make them take a break from their repetitive behaviour and give them new ways to access their hobbies. The other approach departs from Carina Fast's studies on literacy and the potential children have to learn through popular culture, and where I try to base my actions on what they children are currently doing, to elaborate on that instead. I try to apply both of these approaches on my stories, and reflect on how they would work here and what this could lead to. I feel that no two situations are the same and that I can't tell for sure that a certain method is going to work every time, thus I will have to see each and every situation for what it is and try different approaches each time