Borg's rating of perceived exertion scales: do the verbal anchors mean the same for different clinical groups?

Objective: To examine the interpretation of the verbal anchors used in the Borg rating of perceived exertion (RPE) scales in different clinical groups and a healthy control group. Design: Prospective experimental study. Setting: Rehabilitation center. Participants: Nineteen subjects with brain injury, 16 with chronic low back pain (CLBP), and 20 healthy controls. Interventions: Not applicable. Main Outcome Measures: Subjects used a visual analog scale (VAS) to rate their interpretation of the verbal anchors from the Borg RPE 6-20 and the newer 10-point category ratio scale. Results: All groups placed the verbal anchors in the order that they occur on the scales. There were significant within-group differences (P > .05) between VAS scores for 4 verbal anchors in the control group, 8 in the CLBP group, and 2 in the brain injury group. There was no significant difference in rating of each verbal anchor between the groups (P > .05). Conclusions: All subjects rated the verbal anchors in the order they occur on the scales, but there was less agreement in rating of each verbal anchor among subjects in the brain injury group. Clinicians should consider the possibility of small discrepancies in the meaning of the verbal anchors to subjects, particularly those recovering from brain injury, when they evaluate exercise perceptions.

Looking back, moving forward: drama, disability and social justice

The aim of this chapter is to briefly outline how disability has been represented in theatre, what access disabled people have had to drama and theatre in the past, and what might be achieved in the pursuit of social justice with young people in relation to awareness of and provision for disability. It will focus in particular on how disability has been addressed in drama education and what assumptions have been made regarding drama and disability in education. In considering such issues one might perceive manifestations of what Freebody and Finneran (2013) recognise as an overlapping and ‘somewhat artificially created dichotomy between drama for social justice and drama about social justice.’ This chapter will examine some examples of how drama has been used to give students in mainstream schools insights into disability, and the philosophy that underpins the drama curriculum of one special school where the focus is on drama as social justice: the argument being that in some cases simply doing drama is, in effect, a manifestation of social justice. Finally, some of the progress made in recent years regarding access and engagement will be addressed through specific reference to the authors’ on-going work into ‘performing social research’ (Shah, 2013) and how theatres are increasingly attempting to give more access to disabled young people and their families by offering ‘relaxed performances.’

Quantifying sediment transport processes in periglacial mountain environments at a catchment scale using geomorphic process units

The research record on the quantification of sediment transport processes in periglacial mountain environments in Scandimvia dates back to the 1950s. A wide range of measurements is. available, especially from the Karkevagge region of northern Sweden. Within this paper satellite image analysis and tools provided by geographic information systems (GIS) are exploited in order to extend and improve this research and to complement geophysical methods. The processes of interest include mass movements such as solifluction, slope wash, dirty avalanches and rock-and boulder falls. Geomorphic process units have been derived in order to allow quantification via GIS techniques at a catchment scale. Mass movement rates based on existing Field measurements are employed in the budget calculation. In the Karkevagge catch ment. 80% of the area can be identified either as a source area for sediments or as a zone where sediments are deposited. The overall budget for the slopes beneath the rockwalls in the Karkevagge is approximately 680 t a(-1) whilst about 150 : a-1 are transported into the fluvial System.

Boundary layer structure and decoupling from synoptic scale flow during NAMBLEX

This paper presents an overview of the meteorology and planetary boundary layer structure observed during the NAMBLEX field campaign to aid interpretation of the chemical and aerosol measurements. The campaign has been separated into five periods corresponding to the prevailing synoptic condition. Comparisons between meteorological measurements ( UHF wind profiler, Doppler sodar, sonic aneometers mounted on a tower at varying heights and a standard anemometer) and the ECMWF analysis at 10 m and 1100 m identified days when the internal boundary layer was decoupled from the synoptic flow aloft. Generally the agreement was remarkably good apart from during period one and on a few days during period four when the diurnal swing in wind direction implies a sea/land breeze circulation near the surface. During these periods the origin of air sampled at Mace Head would not be accurately represented by back trajectories following the winds resolved in ECMWF analyses. The wind profiler observations give a detailed record of boundary layer structure including an indication of its depth, average wind speed and direction. Turbulence statistics have been used to assess the height to which the developing internal boundary layer, caused by the increased surface drag at the coast, reaches the sampling location under a wide range of marine conditions. Sampling conducted below 10 m will be impacted by emission sources at the shoreline in all wind directions and tidal conditions, whereas sampling above 15 m is unlikely to be affected in any of the wind directions and tidal heights sampled during the experiment.

The factor structure of the Edinburgh postnatal depression scale in a South African peri-urban settlement

The factor structure of the Edinburgh Postnatal Depression scale (EPDS) and similar instruments have received little attention in the literature. The researchers set out to investigate the construct validity and reliability of the EPDS amongst impoverished South African women. The EPDS was translated into isiXhosa (using Brislin's back translation method) and administered by trained interviewers to 147 women in Khayelitsha, South Africa. Responses were subjected to maximum likelihood confirmatory factor analysis. A single factor structure was found, consistent with the theory on which the EPDS was based. Internal consistency was satisfactory (a = 0.89).

Back to the margins in search of the core: "Foreign Land"'s geography of exclusion

The crisis of the national project in the early 1990s, caused by a short-lived but disastrous government, led Brazilian art cinema, for the first time, to look at itself as periphery and re-approach the old colonial center, Portugal. Terra estrangeira/Foreign Land (Walter Salles & Daniela Thomas, Brazil/Portugal, 1995), a film about Brazilian exiles in Portugal, is the best illustration of this perspective shift which provides a new sense of Brazil’s scale and position within a global context. Shot mainly on location in São Paulo, Lisbon and Cape Verde, it promotes the encounter of Lusophone peoples who find a common ground in their marginal situation. Rather than as a former empire, Portugal is defined by its situation at the edge of Europe and by beliefs such as Sebastianism, whose origins go back to the time when the country was dominated by Spain. As a result, notions of “core” or “center” are devolved to the realm of myth. The film’s carefully crafted dialogue combines Brazilian, Portuguese and Creole linguistic peculiarities into a common dialect of exclusion, while language puns trigger visual rhymes which refer back to the Cinema Novo (the Brazilian New Wave) repertoire and restage the imaginary of the discovery turned into unfulfilled utopia. The main characters also acquire historical resonances, as they are depicted as descendants of Iberian conquistadors turned into smugglers of precious stones in the present. Their activities define a circuit of international exchange which resonates with that of globalized cinema, a realm in which Foreign Land, made up of citations and homage to other cinemas, tries to retrieve a sense of belonging.

Back to the margins in search of the core: foreign land's geography of exclusion

The crisis of the national project in the early 1990s, caused by a short-lived but disastrous government, led Brazilian art cinema, for the first time, to look at itself as periphery and re-approach the old colonial centre, Portugal. Terra estrangeira/Foreign Land (Walter Salles & Daniela Thomas, Brazil/Portugal, 1995), a film about Brazilian exiles in Portugal, is the best illustration of this perspective shift aimed at providing a new sense of Brazil’s scale and position within a global context. Shot mainly on location in São Paulo, Lisbon and Cape Verde, it promotes the encounter of Lusophone peoples who find a common ground in their marginal situation. Even Portugal is defined by its location at the edge of Europe and by beliefs such as Sebastianism, whose origins go back to the time when the country was dominated by Spain. As a result, notions of ‘core’ or ‘centre’ are devolved to the realm of myth. The film’s carefully crafted dialogues combine Brazilian, Portuguese and Creole linguistic peculiarities into a common dialect of exclusion, while language puns trigger visual rhymes which refer back to the Cinema Novo (the Brazilian New Wave) repertoire and restage the imaginary of the discovery turned into unfulfilled utopia. The main characters also acquire historical resonances, as they are depicted as descendants of Iberian conquistadors turned into smugglers of precious stones in the present. Their activities define a circuit of international exchange which resonates with that of globalized cinema, a realm in which Foreign Land, made up of citations and homage to other cinemas, tries to retrieve a sense of belonging.

Designing a questionnaire to gather carer input to pain assessment for hospitalized people with dementia

We describe development of a questionnaire to elicit pain symptoms and experience, for use by people with dementia or their carers, at hospital admission. The questionnaire provided contextual information to support professionals’ use of the Abbey Pain Scale, a validated tool used by nursing staff internationally. Appropriate information and physical design were required in order, not only to create an approachable questionnaire for patients and carers, but also to ensure fit with hospital processes. Fit with hospital process had significant influence on the final form of the questionnaire, compromising some aspects of design for patients and carers, but this compromise was considered essential to ensure pain management procedures were supplemented by wider, contextual information.

Dyspnea-related cues engage the prefrontal cortex - evidence from functional brain imaging in COPD

Dyspnea is the major source of disability in chronic obstructive pulmonary disease (COPD). In COPD, environmental cues (e.g. the prospect of having to climb stairs) become associated with dyspnea, and may trigger dyspnea even before physical activity commences. We hypothesised that brain activation relating to such cues would be different between COPD patients and healthy controls, reflecting greater engagement of emotional mechanisms in patients. Methods: Using FMRI, we investigated brain responses to dyspnea-related word cues in 41 COPD patients and 40 healthy age-matched controls. We combined these findings with scores of self-report questionnaires thus linking the FMRI task with clinically relevant measures. This approach was adapted from studies in pain that enables identification of brain networks responsible for pain processing despite absence of a physical challenge. Results: COPD patients demonstrate activation in the medial prefrontal cortex (mPFC), and anterior cingulate cortex (ACC) which correlated with the visual analogue scale (VAS) response to word cues. This activity independently correlated with patient-reported questionnaires of depression, fatigue and dyspnea vigilance. Activation in the anterior insula, lateral prefrontal cortex (lPFC) and precuneus correlated with the VAS dyspnea scale but not the questionnaires. Conclusions: Our findings suggest that engagement of the brain's emotional circuitry is important for interpretation of dyspnea-related cues in COPD, and is influenced by depression, fatigue, and vigilance. A heightened response to salient cues is associated with increased symptom perception in chronic pain and asthma, and our findings suggest such mechanisms may be relevant in COPD.