Objetivo: Avaliar a responsividade da escala de avaliação funcional para pacientes com distrofia muscular de Duchenne (DMD), domínio 1 - sentar e levantar da cadeira (FES-DMD-D1). Método: Estudo observacional, retrospectivo e longitudinal (seguimento por um ano). Foi estudada, utilizando o software FES-DMD-DATA, uma amostra de 150 avaliações da atividade de sentar e levantar da cadeira, a partir de um banco de imagens com filmes de 30 crianças com DMD, executando atividades funcionais, avaliadas a cada três meses, em um período de um ano. A avaliação da FES-DMD-D1 foi aplicada por fisioterapeuta treinado, considerando os escores das fases de flexão, de contato e de extensão da atividade de sentar na cadeira e, das fases de flexão, de transferência e de extensão da atividade de levantar da cadeira. Para avaliar a responsividade da FES-DMD-D1 foram analisadas as avaliações dos períodos de seguimento de três, seis, nove e doze meses, por meio do tamanho do efeito (TE) e da média de resposta padronizada (MRP). Resultados: A responsividade da atividade de sentar na cadeira foi considerada de pequena a moderada nas avaliações a cada três meses (TE de 0,22 a 0,49 e MRP de 0,32 a 0,54), de pequena a moderada a cada seis meses (TE de 0,50 a 0,61 e MRP de 0,41 a 0,61), de pequena a grande a cada nove meses (TE de 0,69 a 1,11 e MRP de 0,49 a 0,79) e grande no período de um ano (TE de 1,07 e MRP de 0,80). Na atividade de levantar da cadeira, a responsividade foi pequena a cada três meses (TE de 0,21 a 0,35 e MRP de 0,28 a 0,45), de pequena a grande a cada seis meses (TE de 0,45 a 0,62 e MRP de 0,50 a 0,96), de moderada a grande a cada nove meses (TE de 0,76 a 0,89 e MRP de 0,74 a 1,47) e grande em um ano (TE de 1,28 e MRP de 1,24). Conclusão: A FES-DMD-D1 mostrou responsividade de moderada a grande, aumentando gradativamente nos intervalos de seis, nove e doze meses. Dessa forma, é indicado o uso da FES-DMD-D1 a partir de seis meses / Objective: To evaluate the responsiveness of the functional evaluation scale for patients with Duchenne muscular dystrophy (DMD) - domain 1: sitting and standing from the chair (FES-DMD-D1). Method: Observational, retrospective and longitudinal study with one year follow-up. A sample of 150 evaluations of sitting and rising from the chair was studied, using the FES-DMD-DATA software, from a bank of images of 30 children with DMD performing functional activities, evaluated every three months in a period of one year. FES-DMD-D1, which explores the scores of the phases of flexion, contact, extension of the activity of sitting on the chair, and of the phases of flexion, transference, extension of the activity of rising from the chair was applied by a trained physiotherapist. To evaluate the responsiveness of FES-DMD-D1 we considered the follow-up evaluations after three, six, nine and twelve months. The analysis used the effect size (ES) and standardized response mean (SRM). Results: The responsiveness of sitting on the chair was considered low to moderate in evaluations with three months intervals (ES from 0.22 to 0.49 and SRM from 0.32 to 0.54), low to moderate with six months intervals (ES from 0.50 to 0.61 and SRM from 0.41 to 0.61), low to high in nine months intervals (ES from 0.69 to 1.11 and SRM from 0.49 to 0.79) and high in the reassessment after one year (ES from 1.07 and SRM from 0.80). The responsiveness of the rising from the chair was low in three months (ES from 0.21 to 0.35 and SRM from 0.28 to 0.45), from low to high in six months (ES from 0.45 to 0.62 and SRM from 0.50 to 0.96), moderate to high in nine months (ES from 0.76 to 0.89 and SRM from 0.74 to 1.47) and high in a year (ES from 1.28 and SRM from 1.24). Conclusion: FES-DMD-D1 showed moderate to high responsiveness, gradually increasing for intervals of six, nine and twelve months. Thus, the use of FES-DMD-D1 is indicated from six months

The clinical diagnostics of olfactory dysfunction in children turns out to be challenging due to low attention span, insufficient linguistic development and lack of odor experiences. Several smell tests have been developed for adults. Most of these examinations take a relatively long time and require a high level of concentration. Therefore, the aim of the current study was to evaluate an odor discrimination and olfactory threshold test using the frequently used “Sniffin’ Sticks” in children and adolescents in a simplified two-alternative-forced-choice version (2AFC) and compare it to the original three-alternative-forced-choice test (3AFC). One-hundred-twenty-one healthy participants aged between 5 and 17 years took part in this study. Within each of the two sessions participants underwent olfactory testing using the modified 2AFC as well as the standard 3AFC method. A better test-retest reliability was achieved using the original 3AFC method compared to the modified 2AFC. This was true for the odor discrimination as well as the olfactory threshold. Age had a significant influence on both tests, which should be considered when testing young children. We discuss these findings with relation to the existing norms and recommend using the 3AFC version due to a better test-retest reliability to measure olfactory function in children.

Die Untersuchung von Gewaltopfern und die Dokumentation von Verletzungen gehört zur Routinetätigkeit in der Klinischen Rechtsmedizin. Am häufigsten werden Folgen stumpfer Gewalteinwirkung festgestellt. Diese Untersuchungen geraten an ihre Grenzen, wenn z.B. Hautunterblutungen (noch) nicht oder bereits nicht mehr sichtbar sind. Die vorliegende Arbeit belegt den Nutzen von ultravioletter (UV) Strahlung zur Sichtbarmachung verblasster und mit bloßem Auge nicht erkennbare Hämatome. Die durch UV-Strahlung hervorgerufene Fluoreszenz von gesundem im Vergleich zu geschädigtem Gewebe kann teils noch bis zu Monate nach einer Verletzung Unterschiede aufweisen. Somit stellt das hier untersuchte Verfahren eine kostengünstige, schnelle und zuverlässige Alternative des Methodenspektrums rechtsmedizinischer Untersuchungstechniken dar.:1. Bibliographische Beschreibung 2. Introduction 3. Background 3.1. Hematoma 3.2. Electromagnetic radiation 3.3. Fluorescence 3.4. UV radiation 3.5. UV-induced fluorescence 3.6. Hematoma fluorescence 3.7. UV-photography 3.8. Alternative non-invasive 4. Motivation & Purpose of this Thesis 5. Publication 6. Summary & Conclusion 6.1. Background 6.2. Aim 6.3. Material and Method 6.4. Results 6.5. Thesis 6.6. Conclusion 7. Appendix 7.1. Bibliography 7.2. Core Data 7.3. Declaration of Independence 7.4. Curriculum vitae 7.5. Publications 7.6. Acknowledgements / Identification and age determination of hematomas is daily work in forensic medicine. Following blunt trauma, a hematoma may be visible between a few hours and up to three weeks. Patients presenting their injuries outside of that timeframe usually miss visual signs. Various studies indicate that ultraviolet radiation (UVR) can aid the process of hematoma identification, when visible signs are vague or even absent. In this thesis hematoma identification using UV- induced fluorescence is discussed as simple, economic and convenient method.:1. Bibliographische Beschreibung 2. Introduction 3. Background 3.1. Hematoma 3.2. Electromagnetic radiation 3.3. Fluorescence 3.4. UV radiation 3.5. UV-induced fluorescence 3.6. Hematoma fluorescence 3.7. UV-photography 3.8. Alternative non-invasive 4. Motivation & Purpose of this Thesis 5. Publication 6. Summary & Conclusion 6.1. Background 6.2. Aim 6.3. Material and Method 6.4. Results 6.5. Thesis 6.6. Conclusion 7. Appendix 7.1. Bibliography 7.2. Core Data 7.3. Declaration of Independence 7.4. Curriculum vitae 7.5. Publications 7.6. Acknowledgements

A quantitative, descriptive, explorative design was used to evaluate a decentralised primary health care training programme at a training unit in the Limpopo Province. The study sought to determine to what extent the newly qualified diplomates were able to manage patients appropriately when faced with the realities, such as the shortage of personnel, large numbers of patients, shortage of resources and time constraints in the real situation without the support and guidance from medical practitioners and senior nursing personnel. Data were collected by observing the diplomates as they managed patients with hypertension by making use of checklists. The diplomates were also interviewed by making use of an in interview schedule. The major inferences drawn from this study was that these diplomates were competent in the management of these patients and were satisfied with their abilities and training. / Health Studies / M. A. (Health Studies)

A marcha é um importante biomarcador na evolução funcional das crianças com distrofia muscular de Duchenne (DMD). A escala de Avaliação Funcional - domínio marcha (FES-DMD-DOMÍNIO MARCHA) foi desenvolvida e teve sua confiabilidade demonstrada em estudo prévio. Atualmente, as escalas funcionais são necessárias para fundamentação da tomada de decisão clínica e como medidas de desfecho em pesquisas científicas e, para tanto, devem ser confiáveis, validas e responsivas. O objetivo do presente estudo foi determinar a responsividade da FES-DMD-domínio marcha no período de um ano, considerando suas três fases e o escore total. Trata-se de estudo observacional, longitudinal e retrospectivo. Foi estudada amostra de 160 avaliações funcionais a partir de filmagens de 32 crianças com DMD (5 a 15 anos). A atividade da marcha foi pesquisada com intervalos de avaliações de 3 meses, totalizando 5 coletas (0, 3, 6, 9 e 12 meses). A responsividade foi analisada por meio dos testes estatísticos tamanho do efeito (TE) e resposta média padronizada (RMP). A responsividade nos intervalos de avaliação de três meses foi considerada de baixa a moderada para as três fases da escala (TE variando de 0.12 a 0.34 e MRP variando de 0.27 a 0.80); de baixa a alta para os intervalos de avaliação de seis meses (TE variando de 0.36 a 0.72 e MRP variando de 0.37 a 1.10); de moderada a alta para os intervalos de avaliação de nove meses (TE variando de 0.70 a 1.0 e MRP variando de 0.50 a 1.43) e alta no período de avaliação de um ano (TE variando de 0.74 a 1.34 e MRP variando de 0.88 a 1.53). O domínio marcha da FES-DMD se mostrou responsivo a partir do intervalo de três meses, aumentado sua capacidade de resposta ao longo das avaliações em até 12 meses. Recomenda-se o uso da FES-DMD-domínio marcha a partir do intervalo de seis meses, que apresenta responsividade, no mínimo moderada para fins de pesquisa, embora seu uso a partir de intervalos de avaliação de três meses possa oferecer informações relevantes nas tomadas de decisão clínico-fisioterapêuticas / March is an important biomarker in the functional evaluation of children with Duchenne muscular dystrophy (DMD). The Functional Scale Evaluation -march domain (FES-DMD-march domain) was developed and its reliability was demonstrated in a previous study. Currently, functional scales are necessary for the reasoning of clinical decision making and as an outcome measure in scientific research and to do so, must be reliable, valid and responsive. The aim of this study was to determine the responsiveness of the FES-DMD-march domain in a one year follow up, considering its three phases and the total score. It is an observational, longitudinal and retrospective study. A sample of 160 functional assessments from filming of 32 children with DMD (5-15 years) was studied. The course of the activity was studied at three monthly intervals evaluations totaling 5 samples (0, 3, 6, 9 and 12 months). Responsiveness was analyzed by statistical tests named effect size (ES) and standardized response mean (SRM). The responsiveness in the three-month evaluation intervals analyzed was considered low to moderate for the three phases of the scale (ES ranging from 0:12 to 0:34 and SRM ranging from 0.27 to 0.80); varied from low to high for the six-months evaluation intervals (ES ranging from 0.36 to 0.72 and SRM ranging from 0:37 to 1:10); varied from moderate to high for the nine-month evaluation intervals (ES ranging from 0.70 to 1.0 and SRM ranging from 0:50 to 1:43) and was high in one year evaluation period (ES ranging from 0.74 to 1.34 and SRM ranging from 0.88 to 1.53). The domain march of the FES-DMD scale showed responsive from the three-month interval, increased their responsiveness during the evaluations within 12 months. It is recommended the use of FES-DMD-march domain from the six-month interval, which presents responsiveness, at least moderate, although its use from three-month evaluation intervals may provide relevant information in clinical-physiotherapeutic decision-making

No description available.

<p><p><strong>Bakgrund: </strong>Smärtor i ben är vanligt förekommande och neuropati (nervskada) är en orsak som troligen är underdiagnostiserad. Bimanuell (tvåhändig/tvåsidig) nervpalpation och känseltest med sporre har visat sig vara ganska tillförlitliga och enkla test för att hitta nervskada men har inte testats på friska individer.</p><p><strong>Syfte: </strong>Syftet var att undersöka om bimanuell nervpalpation i fossa poplitea framkallar smärta/obehag och om det finns skillnad mellan vänster och höger sida vid bimanuell undersökning med sporre på underben hos friska försökspersoner.</p><p><strong>Metod: </strong>Ett bimanuellt palpationstest av nervi tibialis och peroneus i fossa poplitea och även ett bimanuellt känseltest med sporre över dermatomen L4, L5 och S1 på underben genomfördes. Urvalet var ändamålsenligt och totalt deltog 37 försökspersoner. Åldersspannet var 20 till 57 och medianålder 23.</p><p><strong>Resultat: </strong>Vid palpationstestet hade intensiteten av smärta/obehag en median på 1 (variationsvidd 3) på den 11 gradiga skalan. En stor del skattade olika mellan sidorna i både palpationstestet (11 av 37) och känseltestet med sporre (25 av 37). Det var inte någon större skillnad mellan könen.</p><p><strong>Slutsats: </strong>När man utför dessa nervtester måste man ta hänsyn till att även friska individer ofta anger en liten sidoskillnad och inte alltid skattar noll vad gäller smärta/obehag. Det behövs dock fler studier för att bekräfta dessa resultat.</p></p> / <p><strong>Background: </strong>Leg pain is common and neuropathy (nerve disease) is one reason which probably is under diagnosed. Bimanual (bilateral) nerve palpation and sensory test with spurs has been shown to be quite reliable. Furthermore, the tests are straight forward detecting nerve disease but have not been tested on a healthy population.</p><p><strong>Purpose: </strong>The purpose was to investigate whether peripheral nerve palpation in fossa poplitea induces pain/discomfort, and if side difference exists in a sensibility test with spurs on the lower leg in healthy subjects.</p><p><strong>Method: </strong>A bimanual palpation test of the tibial and peroneal nerve in fossa poplitea and also a bimanual sensibility test with spurs of dermatome L4, L5 and S1 on the lower leg were carried out. In order to find healthy subjects a purposive sampling was made. A total of 37 subjects between 20 and 57 years with a median age of 23 participated in the study.</p><p><strong>Results: </strong>At the palpation test the intensity of pain/discomfort had a median of 1 (range 3) in the 11 degrees of pain scale. A large part estimated differences between the sides in both the palpation test (11 of 37) and the sensibility test with spur (25 of 37). There was no significant difference between the sexes.</p><p><strong>Conclusion: </strong>When performing these nerve tests it is important to keep in mind that even healthy individuals might perceive some pain/discomfort as well as side difference. However, we need more studies to confirm these results.</p>

Bakgrund: Smärtor i ben är vanligt förekommande och neuropati (nervskada) är en orsak som troligen är underdiagnostiserad. Bimanuell (tvåhändig/tvåsidig) nervpalpation och känseltest med sporre har visat sig vara ganska tillförlitliga och enkla test för att hitta nervskada men har inte testats på friska individer. Syfte: Syftet var att undersöka om bimanuell nervpalpation i fossa poplitea framkallar smärta/obehag och om det finns skillnad mellan vänster och höger sida vid bimanuell undersökning med sporre på underben hos friska försökspersoner. Metod: Ett bimanuellt palpationstest av nervi tibialis och peroneus i fossa poplitea och även ett bimanuellt känseltest med sporre över dermatomen L4, L5 och S1 på underben genomfördes. Urvalet var ändamålsenligt och totalt deltog 37 försökspersoner. Åldersspannet var 20 till 57 och medianålder 23. Resultat: Vid palpationstestet hade intensiteten av smärta/obehag en median på 1 (variationsvidd 3) på den 11 gradiga skalan. En stor del skattade olika mellan sidorna i både palpationstestet (11 av 37) och känseltestet med sporre (25 av 37). Det var inte någon större skillnad mellan könen. Slutsats: När man utför dessa nervtester måste man ta hänsyn till att även friska individer ofta anger en liten sidoskillnad och inte alltid skattar noll vad gäller smärta/obehag. Det behövs dock fler studier för att bekräfta dessa resultat. / Background: Leg pain is common and neuropathy (nerve disease) is one reason which probably is under diagnosed. Bimanual (bilateral) nerve palpation and sensory test with spurs has been shown to be quite reliable. Furthermore, the tests are straight forward detecting nerve disease but have not been tested on a healthy population. Purpose: The purpose was to investigate whether peripheral nerve palpation in fossa poplitea induces pain/discomfort, and if side difference exists in a sensibility test with spurs on the lower leg in healthy subjects. Method: A bimanual palpation test of the tibial and peroneal nerve in fossa poplitea and also a bimanual sensibility test with spurs of dermatome L4, L5 and S1 on the lower leg were carried out. In order to find healthy subjects a purposive sampling was made. A total of 37 subjects between 20 and 57 years with a median age of 23 participated in the study. Results: At the palpation test the intensity of pain/discomfort had a median of 1 (range 3) in the 11 degrees of pain scale. A large part estimated differences between the sides in both the palpation test (11 of 37) and the sensibility test with spur (25 of 37). There was no significant difference between the sexes. Conclusion: When performing these nerve tests it is important to keep in mind that even healthy individuals might perceive some pain/discomfort as well as side difference. However, we need more studies to confirm these results.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2005. / Härtill 4 uppsatser.

A quantitative, descriptive, explorative design was used to evaluate a decentralised primary health care training programme at a training unit in the Limpopo Province. The study sought to determine to what extent the newly qualified diplomates were able to manage patients appropriately when faced with the realities, such as the shortage of personnel, large numbers of patients, shortage of resources and time constraints in the real situation without the support and guidance from medical practitioners and senior nursing personnel. Data were collected by observing the diplomates as they managed patients with hypertension by making use of checklists. The diplomates were also interviewed by making use of an in interview schedule. The major inferences drawn from this study was that these diplomates were competent in the management of these patients and were satisfied with their abilities and training. / Health Studies / M. A. (Health Studies)