Functioning Core Set Research Articles

The evaluation of daily activity questionnaire for stroke survivors: cross-cultural adaptation, content validity and digitisation

ObjectiveThe study's objective was to culturally adapt and digitise the Evaluation of Daily Activity Questionnaire (EDAQ), originally designed for rheumatoid arthritis and various other musculoskeletal conditions, creating a version for stroke survivors (EDAQ-SS). This adaptation also aimed to develop a comprehensive electronic Patient Reported Outcome Measure (ePROM) intended to refine stroke survivors' self-assessment of their daily activity limitations. Materials and methodsCross-cultural adaptation of the EDAQ was completed by a review of expert panel, which included healthcare professionals to increase the clarity and relevancy of the items, followed by cognitive debriefing interviews with British stroke survivors to rate their understanding of the questionnaire items. After developing the paper version of the questionnaire, this was digitised (eEDAQ-SS) and disseminated online via the Stroke Survivors Hub (SSHUB). Content validity of the EDAQ-SS was evaluated using the International Classification of Functioning (ICF) Core Set for Stroke. ResultsThe expert panel meeting (n:11) and cognitive debriefing interviews with stroke survivors (n:10) resulted in an EDAQ-SS with 160 items across 15 domains, which was understandable and relevant to stroke survivors. The SSHUB was deemed to be a user-friendly platform, providing easy access to eEDAQ-SS and aid self-assessment of daily activities of stroke survivors. Mapping the EDAQ-SS items to the ICF Core Set for Stroke demonstrated good content validity with 44/55 matching categories. ConclusionThe EDAQ-SS offers a comprehensive measure for self-assessment, which may serve to guide stroke survivors’ self-management by overcoming limitations of existing PROMs. Further psychometric testing of the EDAQ-SS and wider testing of the digital version is recommended. Contribution of the Paper•The Evaluation of daily activity questionnaire for stroke survivors (EDAQ-SS) is a culturally adapted, comprehensive PROM for British stroke survivors, enhancing self-assessment of daily activities.•Methodically developed using guidelines, expert feedback, and stroke survivor interviews, the EDAQ-SS ensures relevance and clarity.•The EDAQ-SS demonstrates good content validity against the International Classification of Functioning Core Set for Stroke, with potential to improve clinical practice by providing a detailed, sensitive measure to help stroke survivors and healthcare professionals identify and manage daily activity limitations more effectively.

Penalized optimal scaling for ordinal variables with an application to international classification of functioning core sets.

Ordinal data occur frequently in the social sciences. When applying principal component analysis (PCA), however, those data are often treated as numeric, implying linear relationships between the variables at hand; alternatively, non-linear PCA is applied where the obtained quantifications are sometimes hard to interpret. Non-linear PCA for categorical data, also called optimal scoring/scaling, constructs new variables by assigning numerical values to categories such that the proportion of variance in those new variables that is explained by a predefined number of principal components (PCs) is maximized. We propose a penalized version of non-linear PCA for ordinal variables that is a smoothed intermediate between standard PCA on category labels and non-linear PCA as used so far. The new approach is by no means limited to monotonic effects and offers both better interpretability of the non-linear transformation of the category labels and better performance on validation data than unpenalized non-linear PCA and/or standard linear PCA. In particular, an application of penalized optimal scaling to ordinal data as given with the International Classification of Functioning, Disability and Health (ICF) is provided.

Brief ICF Core Set for Schizophrenia: Development of Criteria for Assessing the Degree of Disability

Introduction: A paradigm shift in the assessment and rehabilitation of people with schizophrenia is needed, with an integrative perspective rather than a simple focus on the underlying symptomatology. To this end, it is essential to adopt integrated and continuous care focused on the person in his/her context. As a contribution, the Brief International Classification of Functioning, Disability and Health (ICF) Core Set for schizophrenia has been developed by international experts. The present study aims to develop a scale to classify the degree of disability for each of the categories of the Brief ICF Core Set for schizophrenia. Methods: The classification criteria were first developed by the researchers and then submitted for assessment by national experts in the area of schizophrenia, using the modified e-Delphi method. Results: Two rounds of questions were asked, and a consensus was reached on the development of the Schizophrenia Functioning Core Set, consisting of all categories of the Brief ICF Core Set for schizophrenia and the criteria for classifying the degree of disability. The degree of agreement of the experts was greater than 90% in all categories. Conclusion: The construction of the disability grading criteria was based on the characteristics of schizophrenia as defined in DSM-V, as well as on some functional assessment scales specifically for this disorder. The development of the Schizophrenia Functioning Core Set allows for reducing the subjectivity in the assessment of the functioning of people with schizophrenia, standardizing the application of criteria to assign the degree of disability in each of the categories.

The expanding world of tissue-resident macrophages.

The term 'macrophage' encompasses tissue cells that typically share dependence on the same transcriptional regulatory pathways (e.g. the transcription factor PU.1) and growth factors (e.g. CSF1/IL-34). They share a core set of functions that largely arise from a uniquely high phagocytic capacity manifest in their ability to clear dying cells, pathogens and scavenge damaged, toxic or modified host molecules. However, macrophages demonstrate a remarkable degree of tissue-specific functionality and have diverse origins that vary by tissue site and inflammation status. With our understanding of this diversity has come an appreciation of the longevity and replicative capacity of tissue-resident macrophages and thus the realisation that macrophages may persist through tissue perturbations and inflammatory events with important consequences for cell function. Here, we discuss our current understanding of the parameters that regulate macrophage survival and function, focusing on the relative importance of the tissue environment versus cell-intrinsic factors, such as origin, how long a cell has been resident within a tissue and prior history of activation. Thus, we reconsider the view of macrophages as wholly plastic cells and raise many unanswered questions about the relative importance of cell life-history versus environment in macrophage programming and function.

Utilization of Extended International Classification of Functioning Core Set for Stroke Patients

Utilization of Extended International Classification of Functioning Core Set for Stroke Patients

Exploratory study of functional and psychological factors associated with employment status in patients with head and neck cancer.

Compared with other malignancies, head and neck cancer (HNC) increases the risk of not returning to work (RTW). Within a cross-sectional study, patients with HNC filled out the OncoFunction questionnaire, a version of the International Classification of Functioning Core Sets for HNC. In 231 patients below 65 years of age, associations of sociodemographic, clinical, functional, and psychological factors with employment and participation in rehabilitation program were explored. Unemployed patients reported more swallowing difficulties and speaking problems. Being unemployed was associated with higher levels of depressive and anxiety symptoms, fatigue, and lower global health. Rehabilitation participation was not significantly associated with any of the assessed factors except for smoking. Unemployed patients with HNC are more burdened than employed patients with HNC regarding clinical, psychological, and functional factors. These differences are more evident later in recovery. Rehabilitation participation was not associated with psychological and functional burden which indicates the need for tailored HNC rehabilitation programs.

Fruclimadapt: An R package for climate adaptation assessment of temperate fruit species

Climate strongly determines the growing range of fruit plant species that can be grown successfully in an area, and also the cultivars that will perform best. Therefore, the assessment of the adequacy of a climate is critical for decision-making in the design of fruit orchards and vineyards, and also for the evaluation of the potential consequences of future climate on fruit production. Bioclimatic indices and plant phenology models are commonly used to assess the suitability of climate for growing quality fruit and to provide temporal and spatial information about regarding ongoing and future changes. In this paper, we present fruclimadapt, a flexible and versatile package in the R language that streamlines the assessment of climate adaptation and the identification of potential risks for grapevines and fruit trees. A core set of functions allows to assess climate adaptation of fruit tree species by calculating specific bioclimatic index values and to evaluate potential threats to yield and fruit quality. Three additional sets of functions have been included as companions to: i) downscale daily meteorological values to hourly data, ii) estimate winter chill and forcing heat accumulation and iii) estimate the occurrence of phenological phases. fruclimadapt is currently available from the CRAN website (https://cran.r-project.org/package=fruclimadapt).

Newborn signal functions in Bangladesh: identification through expert consultation and assessment of readiness among public health facilities—study protocol using Delphi technique

IntroductionThere is a set of globally accepted and nationally adapted signal functions for categorising health facilities for maternal services. Newborn resuscitation is the only newborn intervention which is included in...

Validation and application of the International Classification of Functioning core set for spinal cord injury in the Turkish patients.

The aim of this study was to apply the Comprehensive International Classification of Functioning, Disability and Health (ICF)- Core Set for spinal cord injury (SCI) -early post-acute-situation in the Turkish SCI patients and to investigate its construct validity. One-hundred and twenty patients with SCI were included in this prospective and descriptive study. ICF data were primarily collected by conducting interviews with patients as well as from their acute medical management records, physical examination findings and laboratory measurements. The percentage of participants and the frequency of the problems encountered at each level of ICF category were reported. Furthermore, the construct validity was evaluated by calculating the Spearman correlation between the ICF categories and other generic and disease specific measures. The study illustrated that 55 of the 63 ICF categories of the Component Body Functions (CBF) and each and every category for the Component Body Structures (CBS) as well as the Component Activities and Participation (CAP) were reported as a problem among the Turkish patients with SCI. Furthermore, 24 ICF categories for the Component Environmental Factors (CEF) were determined as a facilitator while 6 ICF categories were identified as a barrier. The ICF-Core Set for SCI illustrated a high construct validity with some of the generic and disease-specific measures. Our results identified the common problems, complications and special needs in a Turkish population with SCI. We suggest that the application of ICF-Core Set in our patients provided us with a unique capability to assess their every aspect of disability, health and functioning.

Linking physical therapy outcome measures to the Brief International Classification of Functioning Core Set for Hand Conditions in subjects with ulnar wrist pain.

The purpose of this study was to apply the Brief International Classification of Functioning (ICF) Core Set for Hand Conditions to the physical therapy outcome measures, and to evaluate the contribution of these measures to overall health in subjects with ulnar wrist pain. Thirty-five subjects with ulnar wrist pain received a 4-week home-based treatment program including orthotics and strengthening exercises. Investigators measured pain, function, grip strength, and overall health four weeks post-intervention. Regression analysis was used to investigate the effect of these variables on overall health represented by the Short Form (SF-36) questionnaire. Fifty-three percent of the variability in SF-36 physical health summary scores was explained by the studied variables with grip strength predicting 31% of the variability. The Brief ICF Core Set for Hand Conditions can be a useful abridged list of categories relevant to functioning and health in subjects with ulnar wrist pain.

Prevalence of Traumatic Brain Injury (TBI) disability: A national population-based survey

Traumatic Brain Injury (TBI) epidemiological literature lacks information on prevalence of TBI-related disability, and on its long-term consequences on a population-based scale. A National Disability and Health Survey was conducted in French households and institutions in 2008–2009. Participants were 33,896 adults representative of 49 million individuals. Face-to-face interviews addressed medical conditions including sequelae from TBI, impairments, activities and participation, health and use of health services. Disability levels of persons with TBI were derived from the Glasgow Outcome Scale. Weighted analyzes were computed including comparisons adjusted on age and gender between persons with or without TBI. Prevalence of self-reported TBI sequelae was 0.7%. Persons with TBI sequelae were men for 62%; median age was 50; median time since injury was 13.9 years. Their disability level was vegetative state for 0.2%, severe disability for 22%, moderate disability for 37%, good recovery for 41%. For all items included in the Brief International Classification of Functioning Core Set for TBI, they declared higher impairments than the no-TBI population, with odds ratios ranging from 1.7 (behavioural difficulties) to 8.6 (motor difficulties). Rates of cardiovascular, respiratory, musculoskeletal, digestive, urological, neurological, and psychiatric conditions were all higher in the TBI population than in the no-TBI population, with highest odds ratios for the last two domains. Use of health care services was higher in the TBI population, and women with TBI had high rates of unmet needs for health services. Chronic sequelae from TBI are frequent and responsible for important disability in the general population. Associations with many other conditions justify lifelong specialized care.

The Intestinal Metabolome: An Intersection Between Microbiota and Host

Recent advances that allow us to collect more data on DNA sequences and metabolites have increased our understanding of connections between the intestinal microbiota and metabolites at a whole-systems level. We can also now better study the effects of specific microbes on specific metabolites. Here, we review how the microbiota determines levels of specific metabolites, how the metabolite profile develops in infants, and prospects for assessing a person's physiological state based on their microbes and/or metabolites. Although data acquisition technologies have improved, the computational challenges in integrating data from multiple levels remain formidable; developments in this area will significantly improve our ability to interpret current and future data sets.

Toward the Development of the International Classification of Functioning Core Sets for Children With Cerebral Palsy

The goal of the International Classification of Functioning is to standardize the classification of health and function of children around the world. To facilitate the application of this classification, International Classification of Functioning-based tools like the "Core Sets" are being developed. We conducted an international survey of professional experts to identify the most relevant areas of functioning in children with cerebral palsy. The questionnaire covered each component of the classification. In total, 193 professionals completed the survey (response rate 78%). Overall, 9706 answers were linked to the classification (pediatric version) by 2 professionals. From the experts' perspective, movement-related areas and social participation are the most relevant areas of functioning. Experts suggest a more comprehensive profile of functioning in particular in areas of personal capacity and social participation. The results of this survey will inform the development of the International Classification of Functioning Core Sets for children with cerebral palsy.

Core Functions of Nursing Home Social Services Departments in the United States

To report social services departmental involvement in 52 functions. Cross-sectional data collected from a nationally representative sample of 1071 nursing home social services directors who were asked to report the extent to which their department was involved in 52 functions (activities). The functions were organized under the framework of the NASW Clinical Indicators for Social Work and Psychosocial Services in Nursing Homes. Nursing home. Social services directors. Not applicable. Self-administered survey. Eighty percent of respondents indicated their department is "usually or always" involved in a core set of 24 functions (out of 52). For each of the 52 functions, at least 40% of departments are at least sometimes involved. Findings reveal both a core set of functions in which departments are "usually or always" involved, as well as many in which some, but not all, departments are involved. This variability of departmental involvement suggests that staff should clearly communicate the functions of their department so that residents, families, fellow staff, and the community know what can be expected. Future research should investigate how to maximize social services to achieve and maintain the highest possible quality of life for residents, address family concerns, and contribute to team effectiveness.

Selection of Ordinally Scaled Independent Variables with Applications to International Classification of Functioning Core Sets

SummaryOrdinal categorial variables arise commonly in regression modelling. Although the analysis of ordinal response variables has been well investigated, less work has been done concerning ordinal predictors. We consider so-called international classfication of functioning core sets for chronic widespread pain, in which many ordinal covariates are collected. The effect of specific international classification of functioning variables on a subjective measure of physical health is investigated, which requires strategies for variable selection. In this context, we propose methods for the selection of ordinally scaled independent variables in the classical linear model. The ordinal structure is taken into account by use of a difference penalty on adjacent dummy coefficients. It is shown how the group lasso can be used for the selection of ordinal predictors, and an alternative blockwise boosting procedure is proposed. Both methods are discussed in general, and applied to international classification of functioning core sets for chronic widespread pain.

Online services for managing information feeds

Purpose – The amount of information on the web increases rapidly, and managing this level of information has always been challenging. The scope of what already exists and recognizing new information resources as they become available adds more complexity. The advent of feed syndication of a site's content makes this task easier. The purpose of this paper is to outline several services offering online organization and management of feeds.Design/methodology/approach – A hands‐on approach was used, focusing on the same core set of functionality across several online feed management services.Findings – It was found that managing existing and discovering new information sources is made easier with the help of online feed management services.Originality/value – The paper presents an overview of Bloglines, Google Reader, and Feedly feed‐reading services.

The GPSTk: an open source GPS toolkit

Applied Research Laboratories, The University of Texas at Austin (ARL:UT) has established a cross platform open source software project called the GPSTk or the GPS Toolkit. The GPSTk consists of a library and collection of applications that support GPS research, analysis, and development. The code is released under the terms of the Lesser GNU Public License. The GPSTk supports a broad range of functionality. This includes reading and writing observations in standard formats, such as RINEX, BINEX, and SP3, ephemeris evaluation, position determination, receiver autonomous integrity monitoring (RAIM), atmospheric delay modeling, cycle slip detection and correction, and P-code generation. The GPSTk provides the core set of functionality that is used for GPS research and development at ARL:UT. ARL:UT has been involved with satellite navigation since Transit (the precursor to GPS) in the 1960s and is currently conducting research in a wide variety of GPS-related fields, including precise surveys, monitor station networks, and ionospheric studies. The GPSTk is a community-wide resource for all users of GPS and GNSS technology. Participation is welcomed in all areas including: bug reports, new algorithms, suggestions for improvement, and contributions of additional functionality or applications. ARL:UT continually improves the library, shepherds community participation, and is committed to the project’s development and maintenance.

Functional status measures for integrating medical and social care

Identify standard self-report questions about functioning suitable for measuring disability across integrated health and social services. Functional activities can be validly grouped according to the International Classification of Functioning, Disability and Health (ICF) chapters of mobility, self-care, and domestic life. Cross-sectional analysis using information on 112,601 persons interviewed as part of the United States National Health Interview Survey on Disability. We combined related sets of questions and tested the appropriateness of their groupings through confirmatory factor analyses. Construct validity was addressed by seeking to confirm clinically logical relationships between the resulting functional scales and related health concepts, including number of physician contacts, number of bed days, perception of illness, and perception of disability. Internal consistency for the summed scales ranged from 0.78 to 0.92. Correlations between the functional scales and related concepts ranged from 0.12 to 0.52 in directions consistent with expectations. Analyses supported the 3 ICF chapters. The routine collection of this core set of functions could enhance decision-making at the client, professional, organizational, and policy levels encouraging cooperation among the medical and social service sectors when caring for people with disabilities.