Limitations In Social Life Research Articles

Indexes of skin activity and damage in patients with systemic lupus erythematosus – CLASI and R-CLASI

Introduction. Cutaneous Lupus Disease Area and Severity Index (CLASI) and its modified version, the Revised Cutaneous Lupus Erythematosus Disease Areas and Severity Index (R-CLASI) are tools for quantifying skin and mucosal lesions in patients with both cutaneous lupus erythematosus and its systemic variant. Evaluation of the scales of activity and skin damage in systemic lupus erythematosus (SLE) is associated with the need to stratify their quantitative characteristics. The Cutaneous Lupus Disease Area and Severity Index (CLASI) and its modified version the Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (R-CLASI) are a tool for quantifying skin and mucosal lesions in patients with both cutaneous lupus erythematosus (CLE) and its system version.Objective. To validate the indexes of objective assessment of skin activity and damage CLASI and R-CLASI in the Russian cohort of patients with systemic lupus erythematosus and compare it with dermatological assessments of the quality of life.Material and methods. The study included 55 patients with SLE with various types of skin and mucosal lesions, the median age was 30.0 [26.0; 40.0] years, the duration of the disease was 7.0 [3.0; 14.0] years. To assess the active (reversible) lesion and irreversible skin damage, the CLASI and R-CLASI indexes were used, for the general assessment of activity and damage in SLE, the SLEDAI-2K and SLICC/ACR DI were used.Results. The most common variant of skin lesions in patients with SLE is acute cutaneous lupus erythematosus (ACLE) – 45%, as well as alopecia, which occurs in 62% of cases. The median activity index for CLASI was 5.0 [2.0; 11.0], and R-CLASI was 7.0 [3.0; 18.0]; the median damage index for CLASI was 5.0 [2.0; 11.0], and R-CLASI was 2.0 [0.0; 7.0]. A significant relationship was revealed between the medians of CLASI and R-CLASI scores depending on the degree of activity according to SLEDAI-2K (Systemic Lupus Erythematosus Disease Activity Index) and the damage Index (DI) in SLE (SLICC/ACR DI, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) when recalculating these indexes only for skin and mucous lesions. According to the ROC analysis, the CLASI and R-CLASI skin activity and damage indices showed high sensitivity (CLASI activity index – 98%, R-CLASI – 93%, CLASI and R-CLASI damage index – 91%) and specificity (CLASI activity index – 64%, R-CLASI – 71%, CLASI and R-CLASI damage index – 86%).Conclusion. To assess the severity of skin and mucosal lesions in patients with SLE in the Russian Federation, it is reasonable to use the CLASI and R-CLASI indices. The CLASI and R-CLASI indices reflect the level of activity and severity of skin lesions, with higher values of these indices indicating more severe skin lesions and a significant impact on the overall well-being of SLE patients. Patients with high values of these indices often experience feelings of embarrassment, discomfort, difficulty in performing daily tasks, and limitations in social life. To assess the severity of skin and mucous lesions in patients with SLE in the Russian Federation, it is advisable to use the CLASI and R-CLASI indexes.

MANFAAT PEMBERIAN JUS NANAS DAN MADU TERHADAP PENURUNAN NYERI DESMINORE PADA REMAJA PUTRI DI SMP YP SINGOSARI DELITUA

Dysmenorrhea is abdominal pain caused by uterine contractions and occurs during menstruation. Dysmenorrhea occurs due to increased secretion of prostaglandin F2a during the luteal phase of the menstrual cycle. Increased secretion of prostaglandin F2 alpha increases the frequency of uterine contractions and as a result can cause abdominal pain in women. The effects of primary dysmenorrhea include disruption of activities, such as absence from school or work, and limitations in social life, school performance, and athletic activities. Non-pharmacological pain management includes warm compresses, drinking lots of fluids, taking regular exercise breaks, consuming nutritious food, pain relief activities such as yoga, and using herbal medicine supplements which are effective in reducing menstrual cramps. Community service was carried out at YP Singosari Delitua Middle School with a total of 20 respondents. According to the results of most students who took part in consultations at YP Singosari Deli Tua Junior High School regarding the effect of pineapple juice and honey in reducing menstrual pain in young women, the level of knowledge is still low due to lack of socialization by providing education regarding the effectiveness of pineapple juice and honey in reducing menstrual cramps. , it is hoped that students can handle this dysmenorrhoea

Reflections of COVID-19 Pandemic on Dermatology Outpatient Clinics

Aim: We aimed to investigate the effects of stress on dermatological diseases that come into our lives with this new infection, which can have vital effects and limitations in social life during the covid 19 pandemic process.Material and Method: In this retrospective study, patients who were examined in the dermatology outpatient clinic during the COVID-19 pandemic (April - May 2020) and the same period last year (April - May 2019) were evaluated. The number of patients who applied, application dates, age and sex of patients, and ICD-10 (International Classification of Diseases-10th Revision) diagnosis codes were recorded by scanning the electronic database of the hospital. Results: The rate of referral to the dermatology outpatient clinic decreased by 6.3 times compared to the previous year. The average age of the patients who applied to the dermatology outpatient clinic during the COVID-19 pandemic period was significantly higher compared to that of the patients who applied during the same period in the previous year. It was observed that during the pandemic period, men applied to the dermatology outpatient clinic significantly more than in the previous year. COVID-19 infection was not detected in patients who applied to the Dermatology outpatient clinic during the early period of the pandemic.Conclusion: While there was a decrease in outpatient consultations for cosmetic reasons, a significant increase in consultations for stress-induced dermatoses was found. Stria rubra development in the young population for reasons such as a sedentary life and possible nutritional disorders as a result of the restrictions experienced during the pandemic period was one of the interesting findings of this period. We think that patients with the coronavirus infection and associated skin findings apply to other clinics instead of the dermatology clinic due to the presence of other accompanying systemic symptoms.

“The Joys of Motherhood” of an African Woman: A Mirage

Quest for identity is one phenomenon of postcolonialism that led way for the emergence of Women writers portraying the indigenous women of their society who were denied the authorial voice in the male-dominated society. Africa African woman literature has always been discussed elaborately not only among ‘White’ but also among fellow African women writers and critics across the globe. Emecheta was one such writer whose work has been criticized for writing after settled in the western country, UK (the colonizer). The readers from third world nations may agree with Emecheta’s call for the necessity to redefine Women’s identity under the African identity. Buchi Emecheta to that reverence has always through her strong woman characters never failed to express the state of the African women and their limitations in social life. Emecheta has always recorded her protagonists' struggle for equality in a male-dominated society. Through the study of her novel The Joys of Motherhood, an attempt is made to explore her perception of Motherhood and explain how she portrays it to the African context where traditions and communal ties are deeply rooted in the Nigerian Ibo society.

Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach.

Abnormal uterine bleeding is the most common complaint that motivates female adolescents to seek medical advice. Abnormal uterine bleeding has a significant impact on quality of life, promoting school absenteeism and limitations in social life. Moreover, episodes can vary from mild to life threatening events if not recognized and treated promptly. Healthcare providers should be able to distinguish between a normal and abnormal menstrual pattern, as this may provide early diagnosis of a potential health concern. The PALM-COEIN classification system should be used in the evaluation. Anovulation is the most frequent cause, frequently due to immaturity of the hypothalamic-pituitary-ovarian axis. A careful history and physical examination are crucial in the differential diagnosis. Management is based on both the underlying cause and the severity of bleeding. Most patients improve with pharmacological treatment, frequently requiring a multidisciplinary approach. First line treatment consists of hormonal therapy. Surgery is rarely needed. Although the prevalence of abnormal uterine bleeding is higher in adolescents compared to adults, most recommendations are not specific for this age, which makes the diagnosis and management challenging. The literature reveals lack of standardized care for adolescents and regimens vary widely. Future studies on efficacy and safety of treatments specifically in adolescents are needed.

Treatment with Delta-9-tetrahydrocannabinol/cannabidiol in Multiple Sclerosis: Influence on the Autonomy Profile according to the International Classification of Functioning, Disability and Health.

The clinical presentation of multiple sclerosis (MS) is heterogeneous but very often lower limb spasticity leads to severe disability.The use of nabiximols improved spasticity control and motor performance in walking, and also had a larger effect in improving activity and participation in personal relationships.Appropriate assessment of MS cases, through the ICF framework, may demonstrate further effects of nabiximols on patient capacity and performance.

Pressure ulcers

Pressure ulcers can significantly affect the quality of life and social inclusion of wheelchair users, in addition to delaying the rehabilitation process and compromising the health-disease process. The aim of this study is to analyze the representation of pressure ulcers in the perception of life/death for wheelchair users. The methodological design of this research is applied, descriptive and participatory, with analysis and discussion of data under a qualitative paradigm. Seven collaborators who are wheelchair users of the Association of Spinal Cord Injuries in Rio Grande do Sul/Brazil (LEME) participated in the interviews. Data analysis was performed by using data categorization and triangulation. The results show the negative impact pressure ulcers have on users’ health and social inclusion. The fear of appearance of pressure ulcers and the associated possibility of death, overlaps other situations that may result from the condition of being a wheelchair user. Users are aware that injuries associated with a bacterial infection can lead to death. The need for constant care and dressings, in addition to the body’s own odor, become important limitations in social life. The importance of the prevention of pressure ulcers is emphasized as a way to promote social inclusion and physical and emotional well-being of users.

The Concept of Smart City in Terms of Improving the Quality and Accessibility of Urban Space for the Elderly; Literature Review

Abstract The paper presents the results of literature review concerned with the possibilities of using ICT for creating a new dimension of accessibility and quality of space. The aim of conducted research was to indicate the main strategies and use ICT as a contribution to the quality of life of the elderly. The article refers to the idea of age-friendly city in connection with the Smart City. As the method a systematic literature review was used, based on the available scientific databases. The results shows that the largest part of project activities in this area involves the use of Internet of Things infrastructure in the field of healthcare and for care services as well as for the maintenance of elderly’s social contacts. Therefore, the concept of Smart City offers the elderly residents many options to compensate for psychophysical dysfunctions and related with them limitations in social life, however, it demands parallel education to develop digital competences for older people.

The problems of the cancer patient's relatives and nursing approach

Cancer; It is a universal health problem that is rapidly increasing in the world and in our country, requiring long-term treatment and care from the time of diagnosis, involving several symptoms. Cancer has a significant impact not only on patients but also on their relatives. Relatives of cancer patients; help patients to meet their needs in numerous areas, such as aiding medical treatment, managing symptoms, problem solving and decision making, providing environmental safety, coordinating care, physical, emotional, social and economic support. Being a caregiver as a relative of the patient, increases their responsibilities by introducing new roles to their usual lives. In the disease process, relatives of patients may have to cope with many problems such as fatigue, depression, role conflict, economic difficulties, limitations in social life and deterioration of immunological systems and physical and mental illness risks. As the prognosis of cancer further deteriorates worse, these problems are exacerbated. In this process, nurses who have a key role in health care need to ameliorate the emotional and social well-being areas of the relatives of the patient by examining the effect of cancer on the relatives of the patient. The nurse should devise a comprehensive training plan for the problems to prevent the caregivers from being adversely affected. They should also apply the training plan and evaluate its results. This review provides information on the emotional, physical and social problems of relatives of cancer patients and the role of nurses in solving these problems.

Prospective association between body mass index at midlife and healthy aging among French adults.

To assess the association between midlife body mass index (BMI) and healthy aging (HA) in the French SU.VI.MAX cohort. HA was assessed in 2007 to 2009 among 2,733 individuals, aged 45 to 60 years and free of diabetes, cardiovascular disease and cancer at baseline (1994-1995). HA was defined as not developing any major chronic disease, good physical and cognitive functioning, no limitations in instrumental activities of daily living, no depressive symptoms, no health-related limitations in social life, good overall self-perceived health, and no function-limiting pain. Associations between anthropometric indicators (measured in 1995-1996) and HA were assessed using robust-error-variance Poisson regression. After adjustment for potential confounders, BMI (continuous) was negatively associated with HA: relative risk (RR) = 0.97 (95% confidence interval = 0.96-0.99). Moreover, the detrimental role of obesity (RRobesity vs. normal weight = 0.67 [0.51-0.88]) was substantially stronger than that of overweight (RRoverweight vs. normal weight = 0.91 [0.81-1.01]). Furthermore, while metabolically healthy individuals with overweight had a similar HA probability as metabolically healthy individuals with normal weight, metabolically unhealthy overweight individuals had a substantially lowered HA probability. This study provides novel evidence that an elevated BMI at midlife may jeopardize the preservation of health during aging. Our results also highlight the importance of maintaining a healthy metabolic profile during midlife.

Quality of life in childhood, adolescence and adult food allergy: Patient and parent perspectives.

Studies of children with food allergy typically only include the mother and have not investigated the relationship between the amount of allergen needed to elicit a clinical reaction (threshold) and health-related quality of life (HRQL). Our aims were (i) to compare self-reported and parent-reported HRQL in different age groups, (ii) to evaluate the impact of severity of allergic reaction and threshold on HRQL, and (iii) to investigate factors associated with patient-reported and parent-reported HRQL. Age-appropriate Food Allergy Quality of Life Questionnaires (FAQLQ) were completed by 73 children, 49 adolescents and 29 adults with peanut, hazelnut or egg allergy. Parents (197 mothers, 120 fathers) assessed their child's HRQL using the FAQLQ-Parent form. Clinical data and threshold values were obtained from a hospital database. Significant factors for HRQL were investigated using univariate and multivariate regression. Female patients reported greater impact of food allergy on HRQL than males did. Egg and hazelnut thresholds did not affect HRQL, but lower peanut threshold was associated with worse HRQL. Both parents scored their child's HRQL better than the child's own assessment, but whereas mother-reported HRQL was significantly affected by limitations in the child's social life, father-reported HRQL was affected by limitations in the family's social life. Severity of allergic reaction did not contribute significantly to HRQL. The risk of accidental allergen ingestion and limitations in social life are associated with worse HRQL. Fathers provide a unique perspective and should have a greater opportunity to contribute to food allergy research.

Dietary scores at midlife and healthy ageing in a French prospective cohort.

Although nutrition has been advocated as a major determinant of healthy ageing (HA), studies investigating the link between dietary quality and HA are scarce. We investigated the association between adherence to French food-based and nutrient-based guidelines at midlife, as assessed by three dietary scores, and HA. HA was assessed in 2007-2009, among 2329 participants of the SUpplémentation en Vitamines et Minéraux AntioXydants study aged 45-60 years at baseline (1994-1995) and initially free of diabetes, CVD and cancer. HA was defined as not developing any major chronic disease, good physical and cognitive functioning, no limitations in instrumental activities of daily living, no depressive symptoms, no health-related limitations in social life, good overall self-perceived health and no function-limiting pain. Data from repeated 24-h dietary records provided at baseline permitted the computation of the modified French Programme National Nutrition Santé-Guideline Score (mPNNS-GS), the Probability of Adequate Nutrient Intake Dietary Score (PANDiet) and the Diet Quality Index-International (DQI-I). Associations of these scores with HA were assessed by logistic regression. In 2007-2009, 42 % of men and 36 % of women met our criteria of HA. After adjustment for potential confounders, higher scores of the mPNNS-GS (ORquartile 4 v. quartile 1 1·44; 95 % CI 1·10, 1·87; P trend=0·006) and the PANDiet (1·28; 95 % CI 1·00, 1·64; P trend=0·03) were associated with higher odds of HA. We observed no association between DQI-I and HA. In conclusion, this study suggests a beneficial long-term role of high adherence to both food-based and nutrient-based French dietary guidelines for a HA process.

A Healthy Dietary Pattern at Midlife, Combined with a Regulated Energy Intake, Is Related to Increased Odds for Healthy Aging

Background: Few studies have investigated the long-term impact of overall dietary patterns (DPs) on healthy aging (HA), and current findings are inconsistent.Objective: Our study’s objective was to investigate the association between empirically derived DPs in midlife and HA after 13 y of follow-up.Methods: Baseline dietary data from repeated 24-h dietary records (on average, 10 records per participant) of a subsample of the SU.VI.MAX (SUpplémentation en Vitamines et Minéraux AntioXydants) study allowed extraction of 2 DPs with the use of principal components analysis on 37 food groups. HA was assessed in 2007–2009 among 2796 participants of the SU.VI.MAX study aged 45–60 y at baseline (1994–1995), who were initially free of diabetes, cardiovascular disease, and cancer. HA was defined as not developing any major chronic disease, good physical and cognitive functioning, no limitations in instrumental activities of daily living, no depressive symptoms, no health-related limitations in social life, good overall self-perceived health, and no function-limiting pain. The association between DPs (in tertiles) and HA was evaluated by using multivariable logistic regression, and a potential interaction with energy intake was investigated.Results: A “Western” and a “healthy” DP were identified. After adjustment for a large number of potential confounders, there was no significant association between the Western DP and HA. Moreover, the healthy pattern was not associated with HA among subjects with high (i.e., greater than or equal to the median) energy intake. Among subjects with low (i.e., less than the median) energy intake, on the other hand, higher scores on the healthy DP were related to higher odds of HA (OR for tertile 3 vs. tertile 1: 1.49; 95% CI: 1.11, 2.00; P-trend = 0.01).Conclusion: Adherence to a healthy diet in midlife that provides micronutrients, fiber, and antioxidants while regulating energy intake may help to promote HA.

The MRC dyspnoea scale by telephone interview to monitor health status in elderly COPD patients

Dyspnoea is the most common symptom associated with poor quality of life in patients affected by Chronic Obstructive Pulmonary Disease (COPD). While COPD severity is commonly staged by lung function, the Medical Research Council (MRC) dyspnoea scale has been proposed as a more clinically meaningful method of quantifying disease severity in COPD. We wished to assess whether this scale might also be useful during telephone surveys as a simple surrogate marker of perceived health status in elderly patients with COPD. We conducted a comprehensive health status assessment by telephone survey of 200 elderly patients who had a physician diagnosis of COPD. The telephone survey contained 71 items and explored such domains as educational level, financial status, living arrangements and social contacts, co-morbid illness, and the severity and the impact of COPD on health status. Patients were categorized according to the reported MRC score: mild dyspnoea (MRC scale of 1), moderate dyspnoea (MRC scale of 2 and 3), or severe dyspnoea (MRC of 4 and 5). Deterioration in most of the recorded indicators of health status correlated with an increasingly severe MRC score. This was most evident for instrumental activities of daily living (IADL), perceived health and emotional status, pain-related limitations, limitations in social life, hospital admissions in preceding year and prevalence of most co-morbidities. The MRC dyspnoea scale is a reliable index of disease severity and health status in elderly COPD patients which should prove useful for remote monitoring of COPD and for rating health status for epidemiological purposes.

Impact of long-term HPN on daily life in adults

Home parenteral nutrition (HPN) is a therapy that changes life radically and often means lifelong dependence on parenteral feeding. The aim of this study was to gain insight into problems experienced by adult patients who were dependent on long-term HPN. A survey was performed on all patients at the ambulatory care clinics of two university centres. We used two techniques: written questionnaires and interviews. The questionnaires addressed fatigue (CIS), quality of sleep, anxiety, depression (BDI), social impairment (subscale SIP68), and sexual functioning. Data were analysed descriptively. Structured interviews inquired about the negative influence of HPN dependence on daily life. These data were quantified by content analysis. The response rate was 76% (n = 48). Questionnaire results: all the respondents had multiple physical symptoms, which they attributed to the underlying disease. Furthermore, severe fatigue (63%), sleeping disorders, (severe) depression (65%), social impairment (55%), and sexual disorders (33%) were present. Quality of life (QoL) correlated with fatigue, sleeping disorders, anxiety, depression, and social impairment (P<0.02). Interview results: psychosocial problems were the main complaints in daily life due to HPN dependence, e.g. negative changes in moods and feelings (including anxiety), lack of freedom, limitations in social life and being dependent. Although many somatic symptoms were present, HPN-dependent patients reported primarily psychosocial problems in daily life. To improve QoL, HPN teams should assess somatic as well as psychosocial aspects standard. Given the large proportion of patients with depressive disorders, therapies such as anti-depressant medication, psychosocial support and cognitive training, should be offered.

Living with an ostomy and short bowel syndrome: Practical aspects and impact on daily life

Purpose: Practical aspects and impact on daily life of short bowel syndrome (SBS) and an ostomy were explored in people with SBS. Interest was focused on nutrition and excretion, ostomy problems, associated medical and surgical problems, socioeconomic situation, and social and leisure activities. Subjects and Setting: Six subjects (range, 38-68 years) with Crohn's disease were included from the University Short Bowel Clinic at Sahlgrenska University Hospital, Gothenburg, Sweden. Average disease duration was 25 years, and mean small intestinal length was 107 cm; 4 subjects were receiving parenteral nutrition at home. Methods: Subjects were interviewed in their homes using a semistructured interview divided into the areas of focus. Data were transcribed by shorthand and were rewritten into the computer the same day. A questionnaire on nutrition and excretion was answered by the subjects in writing and mailed to the interviewer. Results: The most significant observation was the limited ability to act spontaneously, because all daily activities involved considerable planning. Three subjects said they had never accepted the ostomy; the others would not return to their pre-stoma lifestyle. The 2 subjects with a colostomy described special emptying patterns that caused limitations in social life that had not been reported previously. Fistulas were reported as having been the most trying part of the disease. Three subjects worked part time, which was of utmost importance for quality of life. Fatigue influenced social and leisure activities. Conclusion: People with SBS are bothered by a number of demanding problems in various aspects of life. Therefore, a team approach toward care is critical to allow for coordination of action toward the various needs. It also seems unlikely that standard instruments of quality of life can capture the complicated situations with which these subjects live. It appears that coping mechanisms also need to be considered. (J WOCN 2001;28:96-105.)

Bowel function in adults who have sustained spinal cord injury in childhood.

The impact of neuropathic bowel dysfunction on bowel habits was studied in 35 adult spinal cord injury (SCI) patients, who had sustained their injury in childhood. The methods used in the study were clinical interview and examination, quantitative scoring of bowel function (BCS) and estimation of bowel transit time with radiopaque markers. Thirty five healthy subjects without previous anorectal disease or surgery and with similar age and sex distribution as the patients served as controls. Most of the SCI patients were content with their bowel function. Nine (26%) out of 35 of the SCI patients were completely satisfied with their bowel function and reported no limitations in social life. The majority (69%) of the patients considered their bowel function to be significantly altered, causing only mild problems in their social life. Two of the patients had major problems of bowel function, which caused severe limitations in their social life. The majority (77%) of the patients declared that they had a low frequency of bowel evacuation. Eight out of 35 patients were using laxatives to promote bowel emptying. The quantitative BCS of the patients was significantly lower than that of the controls (P < 0.001). Moreover, there was a significant difference between the scores of patients with complete high (C2-T6) and complete low (T7-S4-5) lesions. The difference between the BCS and overall satisfaction with bowel function can be explained by good habilitation to SCI and by the prolonged transit times which enables relatively rare and controlled bowel movements and firm consistency of stools.

The assessment of functional status in the elderly. The application of a Portuguese version of the COOP/WONCA charts

The outcomes of medical care can be measured in terms of health or functional status. Several outcomes measures have been developed in the last years but, there are several difficulties with cross-cultural adaptations. This study is mainly an application exercise to a group of old people of a Portuguese version of the COOP/WONCA charts. A descriptive cross-sectional study with a component of qualitative analysis was done. Population basis was the elderly registered in the lists of five family doctors in two Portuguese health centres (Lumiar and Costa da Caparica) in the Lisbon region. A random sample of 189 patients (aged 65 and over) was interviewed. The studied variables were: gender, age, civil status, literacy, co-morbidity and dimensions of the COOP/WONCA charts. Univariate and bivariate analysis was done. A qualitative analysis was also performed to approach relevancy and acceptability of the charts to the elderly. 23% of the elderly had important limitations (values 4 and 5 of the charts) in physical fitness, 25% had unfavourable repercussions in feelings (values 4 and 5), 12% had important difficulties (value 4 and 5) in every-day life activities and 7% had important limitations in social life. 66% had no changes in their health in the last two weeks, 18% got better and 16% got worse. 21% valued their overall health as fair or poor, 47% as good and 24% as very good or excellent. Moderate to severe pain in the last two weeks was reported by 55% of the patients. Female reported in general worse scores than males. Statistical significance was found in the association between the number of the co-existent health problems in the same person (co-morbidity) and the values of some dimensions of the COOP/WONCA charts. In the half of the cases where the Katz index was measured there were non-concordance with the measures of the daily life of the COOP/WONCA charts. The charts had good acceptability and applicability but also some difficulties for illiterate elderly. Although the use of COOP/WONCA charts could be difficult with elderly patients the present study showed its applicability and utility in the everyday clinical practice. The charts open new possibilities for international comparisons on functional status assessment.