Access to written information for people with aphasia

Background: Accessibility is often constructed in terms of physical accessibility. There has been little research into how the environment can accommodate the communicative limitations of people with aphasia. Communication accessibility for people with aphasia is conceptualised in this paper within the World Health Organisation's International Classification of Functioning, Disability and Health (ICF). The focus of accessibility is considered in terms of the relationship between the environment and the person with the disability. Thus: This paper synthesises the results of three Studies that examine the effectiveness of aphasia-friendly written material. Main Contribution: The first study (Rose, Worrall, & McKenna, 2003) found that aphasia-friendly formatting of written health information improves comprehension by people with aphasia, but not everyone prefers aphasia-friendly formatting. Brennan, Worrall, and McKenna (in press) found that the aphasia-friendly strategy of augmenting text with pictures, particularly ClipArt and Internet images, may be distracting rather than helpful. Finally, Egan, Worrall, and Oxenham (2004) found that the use of ail aphasia-friendly written training manual was instrumental in assisting people with aphasia to learn the Internet. Conclusion: Aphasia-friendly formatting appears to improve the accessibility of written material for people with aphasia. Caution is needed when considering the use of illustrations, particularly ClipArt and Internet images, when creating aphasia-friendly materials. A research, practice, and policy agenda for introducing aphasia-friendly formatting is proposed.

O processo de luto em pessoas idosas defilhadas e a CIF: um estudo exploratório

Introdução: O luto provocado pela morte dos filhos, o defilhar, desperta fortes sentimentos de raiva, culpa e de censura, sendo estas mortes vividas como uma falha na capacidade de dar e proteger a vida. Superar uma perda desta magnitude implica reestruturar psicologicamente e socialmente. Ainda são muito poucos os estudos realizados para identificar e caraterizar estratégias de superação do luto e menos ainda quando dizem respeito ao defilhar. Objetivos: O objetivo deste estudo é analisar numa amostra de mulheres que perderam um filho (defilhadas) com idade igual ou superior a 60 anos, as narrativas de superação do seu processo de luto e mapeá-las à Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Métodos: Foi elaborado um protocolo com os seguintes instrumentos: Short Portable Mental Status Questionnaire (SPMSQ), informações sociodemográficas (idade, género, estado civil, nível educacional, localização geográfica, quantos filhos tem, quando faleceu o filho(a), se foi morte súbita ou esperada, se toma medicação antidepressiva, soníferos ou ansiolíticos e se sim, há quanto tempo), Inventário de Luto Complicado (ILC) e uma entrevista semiestruturada. O protocolo foi administrado a uma amostra de 8 mulheres. Resultados: Os resultados globais sugerem que apesar de grande parte do processo de superação do luto ser bastante emocional, foi possível classificá-lo utilizando o referencial CIF. Dentro do componente ’Funções do Corpo‘, verificou-se o predomínio das funções emocionais nas categorias ‘o que mudou na sua vida’, ‘superação da dor’ e ‘estratégias adotadas’; no componente ‘Atividades e Participação’ destacaram-se aquelas associadas à religião e espiritualidade, nas categorias ‘superação do luto’, ‘estratégias adotadas’ e ‘o que mais gosta de fazer’; no componente ’Fatores Ambientais‘ (‘apoio e relacionamentos’) sobressaiu o apoio proporcionado pela família próxima nas categorias ‘superação da dor’, ‘estratégias adotadas’, apoios físicos ou humanos recebidos’ e ‘o que mais gosta de fazer’. Conclusão: Foi possível mapear à CIF o processo de superação do luto por defilhadas idosas. No entanto, para se obterem dados mais conclusivos, são necessários mais estudos em amostras com maiores dimensões, que abranjam ambos os géneros e com faixas etárias mais amplas. Também é necessário adaptar o protocolo ao referencial CIF de forma a obterem resultados mais precisos.

Fatores associados e preditores de quedas em idosos domiciliados de acordo com a Classificação Internacional da Funcionalidade, Incapacidade e Saúde

Objetivo geral da pesquisa foi identificar os fatores associados e preditivos de quedas em idosos domiciliados em uma cidade do Rio Grande do Sul, Brasil, considerando as características sociodemográficas e epidemiológicas e utilizando-se de fatores ambientais da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Objetivos específicos: identificar as características sociodemográficas e epidemiológicas de idosos domiciliados em uma cidade do Rio Grande do Sul, Brasil; descrever os fatores sociodemográficos e epidemiológicos que influenciam nas quedas em idosos domiciliados; Relacionar os fatores ambientais da Classificação Internacional de Funcionalidade, Incapacidade e Saúde em idosos domiciliados com riscos de quedas. Pesquisa epidemiológica transversal, ocorrida de junho a julho de 2013, com 167 idosos das áreas de abrangência de uma unidade básica de saúde. Critérios de inclusão na pesquisa: ambos os sexos, cadastrados e com residência fixa nas áreas de abrangência de uma unidade básica de saúde. Critérios de exclusão: idosos com alterações cognitivas. Utilizou-se entrevista estruturada com três etapas: levantamento das características dos idosos investigados; questões relacionadas às quedas; informações sobre os fatores ambientais da Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Os dados foram agrupados para tratamento estatístico/descritivo. A média das idades 71 anos, com desvio padrão de 7,1. A maioria dos idosos era do sexo feminino, casados, com escolaridade de quatro e oito anos, residindo com filhos e companheiro, aposentados e com renda de um salário mínimo. As doenças mais prevalentes foram circulatórias, osteomusculares, e endócrinas e os idosos apresentaram pelo menos uma comorbidade. Dos 167 idosos, 65 caíram nos últimos doze meses, no ambiente domiciliar, com prevalência em: banheiro, cozinha e na rua, sendo as calçadas as mais destacadas. A maior proporção de permanência no chão foi de dez minutos, e a maioria dos idosos, após as quedas, não procuraram os serviços de saúde. Como tratamento para as quedas, obteve-se o não cirúrgico. Quanto à Classificação Internacional da Funcionalidade, Incapacidade e Saúde, houve destaque para o uso de medicações como fator influente nas quedas dos idosos domiciliados. Percebe-se a importância de avaliação constante por parte dos profissionais de saúde sobre os idosos caidores e não-caidores, no sentido de identificar os fatores de riscos intrínsecos e extrínsecos para implementar estratégias de prevenção que compreendam reabilitação da força muscular, equilíbrio e capacidade funcional, redução da polifarmácia, educação para o autocuidado e um olhar do enfermeiro voltado para os períodos e locais de maior incidência de quedas, melhorando desta forma a qualidade de vida dos idosos residentes em diferentes contextos. A pesquisa traz como contribuição social um re-olhar acerca do redimensionamento do cuidado à pessoa idosa que teve queda no próprio ambiente, a partir da Classificação Internacional de Funcionalidade, Incapacidade e Saúde.

Estudio comparativo de la baremación de secuelas en diferentes países

El Código Penal Colombiano establece las sanciones para las lesiones no fatales, que varían en rangos de años privativos de la libertad y multa económica en función de los días de incapacidad médico-legal y secuelas que se establecen en una valoración clínica realizada por un médico forense. El Reglamento Técnico Colombiano para el Abordaje Integral de Lesiones en Clínica Forense precisa de manera general cuáles deben ser los días de incapacidad de acuerdo al tiempo estimativo de reparación de los distintos tipos de las lesiones, y determina elementos para establecer las secuelas; sin embargo, no establece gradualidades cuantitativas ni cualitativas para la determinación de las mismas. Se realizó una revisión de los lineamientos jurídicos penales, históricos, conceptuales y médicos en relación a la determinación y valoración de las secuelas en diferentes países. Se utilizaron los motores de búsqueda PubMed, Medline, Google, Science Direct y Springer journal. Se encontró que el proceso de la valoración del daño corporal, desde el ámbito médico-legal, ha evolucionado en relación a las secuelas, se propende por realizar una valoración cuantitativa a través de los procesos de baremación, con el objetivo de unificar los criterios médicos, asegurar respaldo científico y disminuir la litigiosidad de los procesos. En Colombia es deseable realizar un proceso de graduación o baremación cuantitativa de las secuelas, teniendo como base fundamental la ICF (International Classification of Functioning, Disability and Health) y la experiencia de países líderes en el tema, como España y los Estados Unidos, con el propósito de unificar los procesos para la valoración del daño y su respectiva tasación jurídica.

Functional defict and sensitive outcomes to nursing care for elderly: Systematic literature review.

ABSTRACT Objective of this study was to determine sensitive outcomes to nursing care in relation to the functional deficit of people aged 65 and older. It is a Systematic Literature Review with qualitative synthesis and meta-analysis. From the qualitative synthesis, it was found that sensitive outcomes to nursing care, observed from structured intervention, were described as improvement of: functional status, self-care, symptom control, safety/adverse events, customer satisfaction, psychological support, decreased healthcare costs, therapeutic system management and quality of life. In meta-analysis we found that there is an improvement of effect on the level of sensitive outcomes to the nursing care between the experimental and control groups. It is noticed that it is necessary to rouse more guided study in clinical practice, to understand the importance of interventions sensitive to nursing care and health outcomes.

DEVELOPING THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE (ISPRM): FOLLOWING THROUGH

In 2008 the International Society of Physical and Rehabilitation Medicine (ISPRM) started an initiative to systematically develop its capacity and its internal and external policy agenda. This paper sums up achievements that have been made with this ISPRM initiative as well as pending issues and strategies to address them. The paper treats the following: ISPRM`s policy agenda in collaboration with the World Health Organization (WHO), research capacity in functioning and rehabilitation, ISPRM world conferences, relationships with regional societies of Physical and Rehabilitation Medicine (PRM), and ISPRM`s membership and governance structure.

Cross Mapping Of Nursing diagnoses In Infant Health Using the International Classification of Nursing Practice

This was a descriptive, retrospective study, with a quantitative method, with the aim of analyzing the nursing diagnoses contained in the records of children of 0 to 36 months of age who attended infant health nursing consults. A documentary analysis and the cross-mapping technique were used. One hundred eighty-eight different nursing diagnoses were encountered, of which 33 (58.9%) corresponded to diagnoses contained in the Nomenclature of Nursing Diagnoses and Interventions and 23 (41.1%) were derived from ICNP® Version 1.0. Of the 56 nursing diagnoses, 43 (76.8%) were considered to be deviations from normalcy. It was concluded that the infant health nursing consults enabled the identification of situations of normalcy and abnormality, with an emphasis on the diagnoses of deviations from normalcy. Standardized language favors nursing documentation, contributing to the care of the patient and facilitating communication between nurses and other health professionals.


Terms of international classification for Nursing Practice in motor and physical rehabilitation

OBJECTIVE To validate terms of nursing language especially for physical-motor rehabilitation and map them to the terms of ICNP® 2.0. METHOD A methodology research based on document analysis, with collection and analysis of terms from 1,425 records. RESULTS 825 terms were obtained after the methodological procedure, of which 226 had still not been included in the ICNP® 2.0. These terms were distributed as follows: 47 on the Focus axis; 15 on the Judgment axis; 31 on the Action axis; 25 on the Location axis; 102 on the Means axis; three on the Time axis; and three on the Client axis. All non-constant terms in ICNP® have been validated by experts, having reached an agreement index ≥0.80. CONCLUSION The ICNP® is applicable and used in nursing care for physical-motor rehabilitation.

Identification of Races of Selected Isolates of Uromyces appendiculatus from Minas Gerais (Brazil) Based on the new international classification system

Twelve single-pustule isolates of Uromyces appendiculatus, the etiological agent of common bean rust, were collected in the state of Minas Gerais, Brazil, and classified according to the new international differential series and the binary nomenclature system proposed during the 3rd Bean Rust Workshop. These isolates have been used to select rust-resistant genotypes in a bean breeding program conducted by our group. The twelve isolates were classified into seven different physiological races: 21-3, 29-3, 53-3, 53-19, 61-3, 63-3 and 63-19. Races 61-3 and 63-3 were the most frequent in the area. They were represented by five and two isolates, respectively. The other races were represented by just one isolate. This is the first time the new international classification procedure has been used for U. appendiculatus physiological races in Brazil. The general adoption of this system will facilitate information exchange, allowing the cooperative use of the results obtained by different research groups throughout the world. The differential cultivars Mexico 309, Mexico 235 and PI 181996 showed resistance to all of the isolates that were characterized. It is suggested that these cultivars should be preferentially used as sources for resistance to rust in breeding programs targeting development lines adapted to the state of Minas Gerais.

A cash flow-kimutatás szabályozásainak nemzetközi összehasonlítása és csoportosítása (International comparison and classification of Cash Flow Statement regulations)

Az egyes nemzetek számviteli szabályozásának vizsgálatánál az adott ország sajátosságaiból eredően részben eltérő szabályozások alakultak ki. Az induktív megközelítésű vizsgálatok jellemzően a szabályozási kérdések széles körét fogják át, de csak néhány tényező mentén közelítve. A cash flow-kimutatások témakörénél a legtöbbször csak azt nézték, hogy van-e előírás a kimutatás elkészítésére, de a részletekkel már kevésbé foglalkoztak. Ebből adódóan e területen viszonylag kis különbséget mutattak ki ezek a felmérések. A szerző kutatása szerint a nemzeti cash flow-kimutatások szabályozásának részleteiben eltérések tapasztalhatók, és ezek alapján a nemzetek klaszterelemzéssel hierarchikusan csoportokba rendezhetők. _____ Research has found that as a result of their particularities, different countries have established partly different accounting frameworks. Studies with inductive approaches typically encompass a wide range of regulatory issues, but based on a limited number of factors only. In the case of Statements of Cash Flows, most studies have so far only examined the existence of rules governing the presentation of the statement, without an in-depth analysis of the details. Therefore, these studies only found relatively minor differences in this field. The author’s research shows that many differences exist in the details of national Cash Flow Statement regulations, which makes it possible to classify the countries in groups using the method of hierarchical clustering.

Beyond the Acronyms: Sport Diplomacy and the Classification of the International Olympic Committee

Diplomacy often finds itself reduced to actions centred on states. However, after the Cold War, international relations and diplomacy have expanded with different actors growing into significant roles, particularly in the increase of diplomatic relations in the context of sport. The classification and significance of other actors remains under-researched in relation to sport, with literature focusing more on the growth of new and varying practices of diplomacy. This analysis contends that there is a need to interrogate fundamental components of modern diplomacy—with the actor being the focus—more specifically the classification of sports organisations in diplomacy. It is relevant as a more accurate understanding of sports organisations will contribute to how diplomatic studies can analyse and evaluate modern diplomacy within the context of sport. The International Olympic Committee is the actor used to illustrate how problematic classifications currently in the academic literature translate into weak and reduced analysis and evaluation of its role and significance in diplomacy. As counterpoint, this analysis proposes an analytical framework of socio-legal theory that harnesses legal regulation as a benchmark to classify an actor’s capacity within a society. In consequence, the IOC is as an active and significant contributor to the ever expanding and complex diplomatic environment and wider society.

Developing a classification system of social communication functioning of preschool children with autism spectrum disorder

Background: Impairments in social communication are the hallmark feature of autism spectrum disorder (ASD). Operationalizing ‘severity’ in ASD has been challenging; thus stratifying by functioning has not been possible. Purpose: To describe the development of the Autism Classification System of Functioning: Social Communication (ACSF:SC) and evaluate its consistency within and between parent and professional ratings. Methodology: (1)ACSF:SC development based on focus groups and surveys involving parents, educators and clinicians familiar with preschoolers with ASD; and (2)Evaluation of the intra- and inter-rater agreement of the ACSF:SC using weighted kappa(кw). Results: Seventy-six participants were involved in the development process. Core characteristics of social communication were ascertained: communicative intent; communicative skills and reciprocity; and impact of environment. Five ACSF:SC levels were created and content-validated across participants. Best capacity and typical performance agreement ratings varied as follows: intra-rater on 41 children was кw=0.61-0.69 for parents and кw=0.71-0.95 for professionals; inter-rater between professionals were кw=0.47-0.61 and between parents and professionals кw=0.33-0.53. Conclusions: Perspectives from parents, and professionals informed ACSF:SC development, providing common descriptions of the levels of everyday communicative abilities of children with ASD to complement DSM-5. Rater agreement demonstrates the ACSF:SC can be utilized with acceptable consistency in comparison to other functional classification systems.