Permanent Physical Disability Research Articles

Burn injury and fear of rejection: A qualitative study

IntroductionOne of the most important duties of the members of the treatment team is to pay attention to the mental, psychological, and social aspects of burn patients. One of the concerns of these patients during their stay in the hospital is the fear of rejection. The objective of this research is to examine the concept of 'fear of rejection' among patients hospitalized with burn injuries. MethodThis study was conducted between January 2023 and March 2024 in Hamadan, Iran, employing a qualitative content-analysis approach. The study enrolled sixteen patients, and data were collected through deep and semi-structured interviews. The data were then analyzed using the conventional content-analysis approach developed by Graneheim and Lundman. ResultsA group of 16 patients, comprising an equal number of men and women, were interviewed for this study. Based on the data obtained from these interviews, negative brainstorming, frustration, fear of permanent physical disabilities, occupational and financial challenges were identified as categories; visualization of a foggy future and inability in performance of roles emerged as the two themes. ConclusionBased on the results of this study, it can be said that the fear of social rejection, characterized by an inability to perform roles and the visualization of a foggy future, significantly affects the psychological and physical health of burn patients, potentially delaying their recovery. Assisting these patients in reaching their fullest potential to contribute to society post-discharge, and fostering optimism for a promising future, constitute a paramount aspect of daily care and ongoing support.

TACKLING RISING CASES OF STROKE AND HYPERTENSION AMONG YOUNG ADULTS THROUGH STRATEGIC COMMUNICATION IN NIGERIA

Research evidences show that 5 million people die of stroke, and 5 million people are also left with permanent physical disability globally every year, due to the incidence of stroke. Stroke remains the third leading cause of mortality and physical disability among young adults and the aged in the developing and developed nations of the world. The public knowledge of stroke risk factors and signs have not changed. Heart attack and stroke are the symptoms of cardiovascular disease, morbidity and mortality worldwide. Stroke attack is increasing among young adults, due to changing lifestyles. This study assessed the influence of strategic communication on stroke and hypertension literacy. The paper adopted qualitative descriptive approach to examine the elements involved in stroke cases and rising hypertension among young adults in Nigeria. The paper recommends that public health campaigns targeted at youths should aim to promote cardiovascular health and wellness. It is essential for the health care providers to enlighten young adults at early stage to imbibe cardiovascular wellness in Nigeria. Besides, early arrival of stroke patients to stroke centres or hospitals for immediate medical attention should be widely emphasized through public education and strategic communication process in the media.

PEMBERDAYAAN PENDERITA KUSTA DENGAN KECACATAN DERAJAT 2 DAN KELUARGANYA DALAM REHABILITASI DAN PERAWATAN DIRI SECARA MANDIRI

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Leprosy is the main cause of permanent physical disability. Defects in the hands and feet are divided into three levels of disability according to WHO (1988), level 0 (no anesthesia and anatomical abnormalities), level 1 (anesthesia, no anatomical abnormalities) and level 2 (anatomical abnormalities). There is no effective therapy for leprosy disability, so holistic therapy such as medical rehabilitation is needed. The Community Partnership Program (PKM) partner is a leprosy sufferer, a 63 years old woman with grade 2 disability and her family. The patient also experienced paralysis in both legs due to a stroke which was a complication of the diabetes mellitus. The method for implementing PKM activities is by providing training on self-rehabilitation and self-care so that complications due to leprosy disability can prevented, and providing wheelchairs to help partners mobilize. Indicators of achievement include moist extremity skin, no new wounds appearing, contractures on the patient's hands and both of legs not getting worse and the patient getting a wheelchair has reached 100%.

DETERMINING FACTORS OF LEPROSY: A CASE-CONTROL STUDY IN A HYPERENDEMIC AREA OF THE BRAZILIAN LEGAL AMAZON

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It can result in permanent physical disabilities if not diagnosed early. A case-control study was conducted to identify the factors associated with the occurrence of leprosy in individuals living in a region of high incidence of the disease in the Tocantins state in northern Brazil. Sixty cases were diagnosed between 2016 and 2018, and 120 controls were included in the study. The control group consisted of residents from the same area as the cases, the same sex, and with an age variation of up to 5 years. Data were collected through interviews with each participant. Associations were assessed by univariate analysis, followed by logistic regression analysis. The following factors were associated with leprosy in the logistic regression model: households with no more than four rooms (OR = 4.01), absence of a BCG vaccination scar (OR = 2.16), and a previous case of leprosy in the family (OR = 4.32). The data indicated that a close relationship between individuals of the same family in small households, without any immunological protection, and with a history of leprosy cases, significantly increased the risk of M. leprae infection and development of leprosy.

Assessment of hearing sequelae in individuals tested post-trauma.

Over 5% of the global population (430 million people) require rehabilitation for hearing loss. Individuals with hearing impairments face significant challenges in business, daily life, and social participation. Hearing loss (HL) and other permanent physical and sensory disabilities escalate dramatically in cases with brain damage and temporal bone trauma associated with head injuries. This study aims to identify the significant risk factors for hearing loss following head trauma, utilizing current data, and discuss the findings in the context of the literature. This could contribute to the development of standard approaches for assessing such cases. This retrospective study reviewed files and reports from individuals assessed for hearing loss at Dokuz Eylül University Faculty of Medicine, Department of Forensic Medicine. The study included cases that applied at least 12 months post-trauma, between January 1, 2016, and December 31, 2022, after their recovery process was completed. Sociodemographic data, types of temporal bone fractures, initial otoscopic examination findings, presence or absence of intracranial injury, type of hearing loss, and audiometry test results for air and bone conduction pure tone threshold averages were evaluated. Data analysis was conducted using SPSS 26.0 (Statistical Package for the Social Sciences). Out of 244 cases, 177 (72.5%) were male and 67 (27.5%) were female. It was observed that the majority of trauma cases occurred in the 19-40 age group (49.2%; n=120). In the initial otoscopic examinations post-trauma, otorrhagia/otorrhea was the most common finding, both as an isolated symptom (n=59, 24.2%) and when accompanied by other symptoms. No temporal bone fractures were detected in 43 cases (17.6%). Longitudinal fractures were found in 141 cases (57.8%), transverse fractures in 48 (19.7%), and mixed-type fractures in 12 (4.9%). The statistical difference in air conduction and bone conduction pure tone threshold averages between groups with and without intracranial injury was significant (p<0.001). Post-traumatic examinations should employ a multidisciplinary approach, adhering to standard medical improvement and assessment timelines. It is essential to verify whether each patient's medical improvement process has reached its maximum potential. We believe that adhering to these recommendations and utilizing standardized classifications for hearing loss will prevent the loss of rights.

Pengambilan Keputusan Masyarakat Banjar Dalam Pengobatan Ba’urut Pada Patah Tulang

South Kalimantan Province, 2018 Riskesdes data showed that several types of injuries were experienced, including fractures at 4.2 percent, leading to permanent physical disability at 7.2 percent, and the traditional tool-less treatment, ba'ur, was the first choice. This research is a qualitative study with a phenomenological research design with a population of people who experience choosing traditional Ba'urut treatment. This research looks at phenomenology to explore what are the decision-making factors in the community. The samples used in this study are participants with a history of traditional Ba'urut treatment with closed fractures, willing to become participants, participants with adult age restrictions, who communicate well, Ba'urut history is not more than 3 years, domiciled in South Kalimantan.&#x0D; Keywords: Ba’urut; Banjar; Decision Making; Fractur; Traditional Medicine

Prevalence of pulmonary hypertension in chronic simple silicosis patients and its correlation with smoking history, occupation type, age and duration of silica exposure.

Silicosis is a preventable occupational health hazard with potential for permanent physical disability and increased socio-economic burden. Pulmonary hypertension (PH) secondary to chronic respiratory diseases signifies poorer prognosis and transthoracic echocardiography (TTE) has proven its usefulness as a screening tool for PH diagnosis. The objectives were to determine PH prevalence in chronic simple silicosis patients through TTE screening and correlate PH prevalence with smoking status, occupation type, age and duration of silica exposure (DSE). We enrolled 104 patients in the study based on occupational exposure to silica dust and radiologic confirmation of chronic simple silicosis. The study sample was divided into significant smokers (SS group) and insignificant smokers (InS group) on the basis of ≥10 pack years smoking history, and into drillers and dressers based on occupation type. TTE examination was performed to measure resting mean pulmonary artery pressure (mPAP) and the patients were classified into: no PH (mPAP≤20 mm Hg), borderline PH (mPAP>20 and <25 mmHg), and PH (mPAP≥25). PH prevalence was 25% in study subjects (26/104); 29.6% (16/54) among SS group versus 20% (10/50) among InS group (.52) ; and 34.2% (14/41) among drillers versus 19.1% (12/63) among dressers (p=.024). Mean age and mean duration of silica exposure among SS and InS groups were comparatively similar, while they had lower values among dressers against dressers with no statistical significance. Logistic regression analysis established a significant association of PH prevalence with higher age in the study sample, SS group and drillers group, while a significant association of PH prevalence with longer DSE was only seen in the study sample. PH prevalence was significantly associated (p=.007) with SS-driller group on comparing TTE findings with combined smoking and occupation type based groups. This study has shown PH prevalence in chronic simple silicosis patients at alarming levels, having associations with driller occupation, older age and longer DSE with varying results among groups and complex interplay with smoking exposure, suggesting the need for large sample-based molecular and genetic studies. Including TTE in the initial work-up of silicosis patients will promote timely intervention and reduce morbidity and mortality with a high benefit-cost ratio.

Modeling Survival Time to Death among Stroke Patients at Jimma University Medical Center, Southwest Ethiopia: A Retrospective Cohort Study.

Stroke is a life-threatening condition that occurs due to impaired blood flow to brain tissues. Every year, about 15 million people worldwide suffer from a stroke, with five million of them suffering from some form of permanent physical disability. Globally, stroke is the second-leading cause of death following ischemic heart disease. It is a public health burden for both developed and developing nations, including Ethiopia. This study is aimed at estimating the time to death among stroke patients at Jimma University Medical Center, Southwest Ethiopia. A facility-based retrospective cohort study was conducted among 432 patients. The data were collected from stroke patients under follow-up at Jimma University Medical Center from January 1, 2016, to January 30, 2019. A log-rank test was used to compare the survival experiences of different categories of patients. The Cox proportional hazard model and the accelerated failure time model were used to analyze the survival analysis of stroke patients using R software. An Akaike's information criterion was used to compare the fitted models. Of the 432 stroke patients followed, 223 (51.6%) experienced the event of death. The median time to death among the patients was 15 days. According to the results of the Weibull accelerated failure time model, the age of patients, atrial fibrillation, alcohol consumption, types of stroke diagnosed, hypertension, and diabetes mellitus were found to be the significant prognostic factors that contribute to shorter survival times among stroke patients. The Weibull accelerated failure time model better described the time to death of the stroke patients' data set than other distributions used in this study. Patients' age, atrial fibrillation, alcohol consumption, being diagnosed with hemorrhagic types of stroke, having hypertension, and having diabetes mellitus were found to be factors shortening survival time to death for stroke patients. Hence, healthcare professionals need to thoroughly follow the patients who pass risk factors. Moreover, patients need to be educated about lifestyle modifications.

Dampak Buruk Stunting Bagi Anak pada Usia Golden Age di Desa Pasiran Kecamatan Sei Dadap Kabupaten Asahan

Stunting is a condition where a child's height is shorter than a child of the same age, with a Z-score for height for age (TB/U). Based on the standard of growth reached less than -2 standard deviation (SD). Poor nutrition during the first 1000 days of life causes growth retardation in children. Affected children have permanent physical developmental disabilities that affect their ability to work. The average IQ of retarded children is 11 points lower than the average IQ of children in the general population. The research method used in this research is a systematic review of published literature from national and international publications. The object of this research is in Pasiran Village, Sei Dadap District, Asahan Regency. The results of this study reveal that children who experience stunting in the first 2 years of life are at risk of having an IQ of 4.57 and a nonverbal IQ of less than 89.

Reaching those at risk: Active case detection of leprosy and contact tracing at Kokosa, a hot spot district in Ethiopia.

Leprosy is a chronic mycobacterial disease of public health importance. It is one of the leading causes of permanent physical disability. The prevalence of leprosy in Ethiopia has remained stagnant over the last decades. The aim of the study was to identify new leprosy cases and trace household contacts at risk of developing leprosy by active case detection. The study area was Kokosa district, West Arsi zone, Oromia region, Ethiopia. A prospective longitudinal study was conducted from June 2016-September 2018 at Kokosa district. Ethical approvals were obtained from all relevant institutions. Health extension workers screened households by house-to-house visits. Blood samples were collected and the level of anti-PGL-I IgM measured at two-time points. More than 183,000 people living in Kokosa district were screened. Dermatologists and clinical nurses with special training on leprosy confirmed the new cases, and their household contacts were included in the study. Of the 91 new cases diagnosed and started treatment, 71 were recruited into our study. Sixty-two percent were males and 80.3% were multibacillary cases. A family history of leprosy was found in 29.6% of the patients with cohabitation ranging from 10 to 30 years. Eight new leprosy cases were diagnosed among the 308 household contacts and put on multi-drug therapy. The New Case Detection Rate increased from 28.3/100,000 to 48.3/100,000 between 2015/2016 and 2016/2017. Seventy one percent of leprosy patients and 81% of the household contacts' level of anti-PGL-I IgM decreased after treatment. In conclusion,the results of the study showed the importance of active case detection and household contact tracing. It enhances early case finding, and promotes early treatment, thereby interrupting transmission and preventing potential disability from leprosy.

Analisis Praktik Klinik Keperawatan Pada Pasien Stroke Non Hemoragik dengan Pemberian Latihan Pemasangan Puzzle Jigsaw Terhadap Peningkatan Kekuatan Otot Ekstermitas Atas Rsud Prof. Dr. H. Aloei Saboe Kota Gorontalo

Stroke is an acute neurological condition caused by decreased blood flow to the brain. Nervous system dysfunction occurs suddenly (within seconds) or rapidly (within hours) and the symptoms and signs correspond to the local area of ​​the brain affected.&#x0D; Objective: To conduct an analysis of managed cases with a medical diagnosis of non-hemorrhagic stroke with jigsaw puzzle pairing exercise therapy to increase upper extremity muscle strength&#x0D; Methods: This research is a quasi-experimental design with pre and post test. This type of research is a research design that is used to look for causal relationships with research involvement. The sample used in this study were 6 patients with a critical sample of patients who had non-hemorrhagic stroke who were treated at Prof. Hospital. Dr. Aloei Saboe Gorontalo City.&#x0D; Results: The results of the study showed that changes in muscle strength were only present in Mr. I.T obtained an increase on the evaluation of the third day of implementation where there was an increase in muscle strength to 5/4, which means there was an increase using the MMAS (Modified Muscle Assessment Scale) it was found that the client was only able to lift the top part of the puzzle and put it back. (The patient reaches forward at arm's length, lifts the top of the puzzle, releases it back to the part of the table that is closest to the patient's body).&#x0D; Conclusion: Based on the research conducted, it was found that 6 respondents from the results of the assessment had measuring results that had been carried out after the Jigsaw Puzzle installation exercise, it was found that there was a change in the range of motion of the client's fingers while for the client's muscle strength and fine motor movements there had been no change. Stroke attack can cause permanent physical disability.

Investigation of Factors That Affect the Quality of Life After a Stroke.

Stroke, as a disease, describes a group of disorders characterized by the presence of central nervous system symptoms either as a result of ischemia (ischemic stroke) or bleeding (hemorrhagic stroke). The appearance of a stroke results in a permanent physical or cognitive disability. The stroke incidence is the third cause of death after heart disease and cancer, and is the main cause of long-term disability.The effects of a stroke on a patient's daily life, and hence on his quality of life, are intense and long-lasting. These include memory problems, speech difficulty, depression, reduced vision loss, and decreased walking ability. This limitation of the patient's motor activity has a direct negative impact on the quality of his life.To investigate the degree of this impact, a research was carried out at a hospital of Central Greece. The total sample consisted of 90 patients and the responses showed that post-stroke symptoms are significant. Consequences and treatment control of the disease on the life of the sample were the questions with the highest score showing the significant effect that a stroke has on life the patients.More specifically, the sample showed through responses that the disease affects their lives to a great extent. The pre-stroke scores on the domains of the sample are clearly higher than post-stroke. The highest difference was found in the use of the upper extremities in self-care and family roles while the lowest was found in the domain of thinking. The most affected domains were as follows: thinking, vision, and language. Alternatively, the least affected domain was family roles.

Experiences of spinal cord injury patients admitted to the rehabilitation unit at the national referral hospital in Khomas region, Namibia.

BackgroundSpinal cord injury (SCI) remains one of the major causes of disability globally. It results in permanent physical disability secondary to devastating neurological defects. When a person sustains SCI, substantial changes and challenges in their lives occur, regardless of their age or socioeconomic status. In Namibia, the knowledge on SCI experiences could be used to improve the care rendered to patients with this injury.ObjectivesThe purpose of this study was to explore and describe the experiences of patients with SCIs admitted to the rehabilitation unit at the national referral hospital in Khomas region, Namibia.MethodA qualitative, explorative and descriptive study design was used. Data were collected by means of in-depth, semi-structured, face-to-face interviews with 15 participants from the rehabilitation unit. Data were analyzed using thematic analysis.ResultsAnalysis of the data in this study identified three themes: negative experiences, positive experiences and measures to improve the lives of people living with SCI in the community. Participants experienced varied emotions from anger, stress, disbelief, frustration and sadness, which led to depression. In addition, participants experienced discrimination due to lack of community acceptance hence, improving awareness remains key.ConclusionThis study provided insight into the lived experiences of those living with SCI as they narrated their struggle from the onset of SCI to their reintegration into the community. The study’s findings can be used to develop self-care strategies and ongoing interventions that focus on maintaining physical and psychological health for spinal-cord injured persons throughout the course of living with disability.

Prevalence and Risk Factors of Achilles Tendinopathy among University Soccer Players

Tendinopathies especially that of the Achilles account for a significant amount of overuse injuries in sports that could hinder optimal performance in sport, might lead to permanent physical damage or disability, and it's epidemiology is not extensively documented in our clime. Therefore, this study aimed to determine the prevalence and risk factors associated with Achilles Tendinopathy (AT) among university soccer players.

IPTEK BAGI MASYARAKAT (IbM) PENYULUHAN TENTANG PEMBERIAN MAKANAN TAMBAHAN (PMT) PADA BALITA DI WILAYAH KERJA PUSKESMAS MULTIWAHANA PALEMBANG TAHUN 2016

Malnutrition is a major problem in the world that does not only occur in developing countries but also in developed countries (Freeman L). More than 3.5 million mothers and children under five every year are caused by malnutrition, and millions more experience permanent physical and mental disabilities as a result of lack of food intake in early life (Lancet, 2011). Based on the 2013 Riskesdas data, the prevalence of undernutrition was 12.1% in 2013. In the province of South Sumatra in 2013 the prevalence of undernutrition in children under five was 12.1% (Ministry of Health, 2014). In children under five with malnutrition, efforts need to be made so that they do not become malnourished and even increase their nutritional status. The effort that needs to be done is by providing additional food (PMT) for recovery (Kemenkes RI, 2011). PMT Recovery is intended as an addition, not as a substitute for the main daily meal. The PMT is based on local food ingredients with regional specialties adapted to local conditions (Directorate General of Nutrition and Maternal and Child Health, Ministry of Health, RI, 2012). This community service aims to improve the nutritional status of toddlers in the work area of ​​the Multiwahana Palembang Health Center by conducting counseling and distributing leaflets/posters about the Provision of Supplementary Foods (PMT) to toddlers to mothers who have babies and toddlers in the work area of ​​the Palembang Multiwahana Health Center. During the outreach activities, the community was very enthusiastic about listening and asking questions about good eating for infants and toddlers. This community service is expected to increase the knowledge and skills of the community in improving the nutritional status of toddlers by providing additional food according to the age of infants and toddlers.

Sleep disorders among Aboriginal Australians with Machado-Joseph Disease: Quantitative results from a multiple methods study to assess the experience of people living with the disease and their caregivers

BackgroundMachado-Joseph Disease (MJD), or Spinocerebellar Ataxia Type 3 (SCA3), is a genetic disorder that causes progressive muscle weakness, loss of motor control, ataxia and permanent physical disability. Sleep disturbances are associated with MJD but remain poorly understood. ObjectiveTo investigate frequency and characteristics of sleep disorders and their association with health-related quality of life and psychosocial wellbeing for Aboriginal Australians living with MJD. MethodsA convenience sample of MJD participants n = 24 participated in a semi-attended, ambulatory diagnostic sleep study to capture polysomnography, actigraphy and sleep diary data. Self-report measures collected were the Pittsburgh Sleep Quality Index (PSQI), STOP-BANG Questionnaire for Obstructive Sleep Apnoea (OSA), International Restless Legs Syndrome Study Group rating scale (IRLS), Kessler-5 (K5) and EuroQoL-5 Dimension (EQ5D). Caregivers (n = 22) reported EQ-5D, K5 and bed partners’ sleep behaviour (Mayo Sleep Questionnaire-Informant). Environmental factors were measured. ResultsWe observed Nocturia, Sleep Related Leg Cramps, OSA, REM Behaviour Disorder, and RLS, respectively in 100%, 71%, 47%, 43%, and 33% of participants with a significant positive correlation between Body mass index (BMI) and Apnoea hypopnea index (AHI). The majority of sleep was spent in non-rapid eye movement sleep (NREM)-N2 stage (77.8% (67.7, 81.6)). Overcrowding (92%) and overnight care needs (42%) interrupted sleep. MJD participants and caregivers reported high psychological distress (K5 median 12.5 IQR 7, 16.5 & 8 IQR 6, 12 respectively). ConclusionPoor sleep quality and sleep disturbances are prevalent among this cohort. Disease manifestations and environmental factors are driving factors. Larger sample sizes are required to predict risk factors and confirm observed associations.

Trends in pneumoconiosis in Brazil, 1979-2019.

Pneumoconiosis is a lung disease related to exposure to dust in the workplace. The disease can induce irreversible damage to health, especially in lung tissue, and can cause progressive and permanent physical disabilities. This study evaluated the temporal and spatial distribution of mortality rates (1979-2019) and hospital admissions (1995-2019) for pneumoconiosis in Brazil. The outcomes were hospitalization and death due to pneumoconiosis: codes 500-506 according to the ICD-9 and J60-J66 according to the ICD-10. Data from this retrospective ecological study were collected from the Brazilian Ministry of Health database. Hospitalization for pneumoconiosis has decreased in all regions of Brazil. Hospitalizations occurred predominantly in men aged over 40 years. Death rates showed a temporal increase in all regions. Deaths occurred predominantly in men aged over 50 years. The highest hospitalization and death rates were in the states of the Midwest and South Regions. Pneumoconiosis is a preventable occupational disease, and ongoing occurrences of hospitalizations and deaths highlight the importance of inspecting industries and controlling occupational and environmental exposures.

Oxidative stress and mitochondrial dysfunction following traumatic brain injury: From mechanistic view to targeted therapeutic opportunities.

Traumatic brain injury (TBI) is one of the most prevalent causes of permanent physical and cognitive disabilities. TBI pathology results from primary insults and a multi-mechanistic biochemical process, termed as secondary brain injury. Currently, there are no pharmacological agents for definitive treatment of patients with TBI. This article is presented with the purpose of reviewing molecular mechanisms of TBI pathology, as well as potential strategies and agents against pathological pathways. In this review article, materials were obtained by searching PubMed, Scopus, Elsevier, Web of Science, and Google Scholar. This search was considered without time limitation. Evidence indicates that oxidative stress and mitochondrial dysfunction are two key mediators of the secondary injury cascade in TBI pathology. TBI-induced oxidative damage results in the structural and functional impairments of cellular and subcellular components, such as mitochondria. Impairments of mitochondrial electron transfer chain and mitochondrial membrane potential result in a vicious cycle of free radical formation and cell apoptosis. The results of some preclinical and clinical studies, evaluating mitochondria-targeted therapies, such as mitochondria-targeted antioxidants and compounds with pleiotropic effects after TBI, are promising. As a proposed strategy in recent years, mitochondria-targeted multipotential therapy is a new hope, waiting to be confirmed. Moreover, based on the available findings, biologics, such as stem cell-based therapy and transplantation of mitochondria are novel potential strategies for the treatment of TBI; however, more studies are needed to clearly confirm the safety and efficacy of these strategies.

Shaping Quality of Life with Nursing Assistance. A Grounded Theory Approach to Nursing Care for People with Physical Disabilities and Interactions with Carers in Long-Term Care

<strong>Context:</strong> Although the number of people with physical disabilities who need nursing support is increasing, there is a lack of empirical knowledge about how they experience necessary care support. This knowledge is a prerequisite for enabling self-determination in the provision of care and for providing care based on needs and requirements. People with physical disabilities live in residential institutions and their own homes with the support of care services, and they are dependent on permanent nursing assistance. <strong>Objective: </strong>This qualitative grounded theory study describes the importance that people with physical disabilities ascribe to the provision of care and how they organise their cooperation with caregivers. <strong>Methods:</strong> Twenty-seven problem-centred interviews with people who had a permanent physical disability and a need for care were analysed using the grounded theory approach. <strong>Findings: </strong>People with physical disabilities and a need for care want to enhance their quality of life with assistance. Quality of life is influenced by their wishes regarding assistance, acceptance of the physical disability, (previous) experience with assistance and the possibility of actively influencing the implementation of necessary assistance. The development and maintenance of a friendly relationship with professional carers represent a strategy for achieving quality of life. <strong>Limitations:</strong> This study focuses on people with physical disabilities who receive care from a professional service. Questions about the influence on family carers remain unanswered. <strong>Implications: </strong>For successful social participation, people with physical disabilities should be supported by nursing professionals to identify and express their priorities and needs.

MicroRNAs as Biomarkers for Predicting Complications following Aneurysmal Subarachnoid Hemorrhage.

Aneurysmal subarachnoid hemorrhage (aSAH) is a high mortality hemorrhagic stroke that affects nearly 30,000 patients annually in the United States. Approximately 30% of aSAH patients die during initial hospitalization and those who survive often carry poor prognosis with one in five having permanent physical and/or cognitive disabilities. The poor outcome of aSAH can be the result of the initial catastrophic event or due to the many acute or delayed neurological complications, such as cerebral ischemia, hydrocephalus, and re-bleeding. Unfortunately, no effective biomarker exists to predict or diagnose these complications at a clinically relevant time point when neurologic injury can be effectively treated and managed. Recently, a number of studies have demonstrated that microRNAs (miRNAs) in extracellular biofluids are highly associated with aSAH and complications. Here we provide an overview of the current research on relevant human studies examining the correlation between miRNAs and aSAH complications and discuss the potential application of using miRNAs as biomarkers in aSAH management.