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The 39 item Parkinson's disease questionnaire (PDQ-39) revisited: implications for evidence based medicine.

https://arctichealth.org/en/permalink/ahliterature164059
Source
J Neurol Neurosurg Psychiatry. 2007 Nov;78(11):1191-8
Publication Type
Article
Date
Nov-2007
Author
Peter Hagell
Carita Nygren
Author Affiliation
Department of Health Sciences, Lund University, PO Box 157, SE-221 00 Lund, Sweden. Peter.Hagell@med.lu.se
Source
J Neurol Neurosurg Psychiatry. 2007 Nov;78(11):1191-8
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adult
Aged
Aged, 80 and over
Antiparkinson Agents - therapeutic use
Cognition Disorders - diagnosis - drug therapy - psychology
Disability Evaluation
Evidence-Based Medicine
Female
Geriatric Assessment - statistics & numerical data
Humans
Levodopa - therapeutic use
Male
Middle Aged
Mobility Limitation
Parkinson Disease - diagnosis - drug therapy - psychology
Psychometrics - statistics & numerical data
Quality of Life - psychology
Questionnaires
Reproducibility of Results
Sick Role
Sweden
Abstract
The 39 item Parkinson's disease questionnaire (PDQ-39) is the most widely used patient reported rating scale in Parkinson's disease. However, several fundamental measurement assumptions necessary for confident use and interpretation of the eight PDQ-39 scales have not been fully addressed.
Postal survey PDQ-39 data from 202 people with Parkinson's disease (54% men; mean age 70 years) were analysed regarding psychometric properties using traditional and Rasch measurement methods.
Data quality was good (mean missing item responses, 2%) and there was general support for the legitimacy of summing items within scales without weighting or standardisation. Score reliabilities were adequate (Cronbach's alpha 0.72-0.95; test-retest 0.76-0.93). The validity of the current grouping of items into scales was not supported by scaling success rates (mean 56.2%), or factor and Rasch analyses. All scales represented more health problems than that experienced by the sample (mean floor effect 15%) and showed compromised score precision towards the less severe end.
Our results provide general support for the acceptability and reliability of the PDQ-39. However, they also demonstrate limitations that have implications for the use of the PDQ-39 in clinical research. The grouping of items into scales appears overly complex and the meaning of scale scores is unclear, which hampers their interpretation. Suboptimal targeting limits measurement precision and, therefore, probably also responsiveness. These observations have implications for the role of the PDQ-39 in clinical trials and evidence based medicine. PDQ-39 derived endpoints should be interpreted and selected cautiously, particularly regarding small but clinically important effects among people with less severe problems.
Notes
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PubMed ID
17442762 View in PubMed
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Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents.

https://arctichealth.org/en/permalink/ahliterature139831
Source
Int J Health Geogr. 2010;9:52
Publication Type
Article
Date
2010
Author
Antonio Paez
Ruben G Mercado
Steven Farber
Catherine Morency
Matthew Roorda
Author Affiliation
School of Geography and Earth Sciences, McMaster University, Hamilton Ontario, Canada. paezha@mcmaster.ca
Source
Int J Health Geogr. 2010;9:52
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Health Services Accessibility - statistics & numerical data
Humans
Middle Aged
Mobility Limitation
Quebec
Regression Analysis
Residence Characteristics
Socioeconomic Factors
Transportation - statistics & numerical data
Young Adult
Abstract
Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required.
Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold) for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons.
The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists).
Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be significantly less mobile than people of other age cohorts. The combination of average trip length estimates with the spatial distribution of health care facilities indicates that despite being more mobile, suburban residents tend to have lower levels of accessibility compared to central city residents. The effect is more marked for seniors. Furthermore, the results indicate that accessibility calculated using a fixed bandwidth would produce patterns of exposure to health care facilities that would be difficult to achieve for suburban seniors given actual mobility patterns.
The analysis shows large disparities in accessibility between seniors and non-seniors, between urban and suburban seniors, and between vehicle owning and non-owning seniors. This research was concerned with potential accessibility levels. Follow up research could consider the results reported here to select case studies of actual access and usage of health care facilities, and related health outcomes.
Notes
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PubMed ID
20973969 View in PubMed
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Accomplishment level and satisfaction with social participation of older adults: association with quality of life and best correlates.

https://arctichealth.org/en/permalink/ahliterature144806
Source
Qual Life Res. 2010 Jun;19(5):665-75
Publication Type
Article
Date
Jun-2010
Author
Mélanie Levasseur
Johanne Desrosiers
Gale Whiteneck
Author Affiliation
School of Rehabilitation, Université de Sherbrooke, 3001 12ième avenue Nord, Sherbrooke, QC, J1H 5N4, Canada. Melanie.Levasseur@USherbrooke.ca
Source
Qual Life Res. 2010 Jun;19(5):665-75
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Age Factors
Aged
Aging
Analysis of Variance
Community Networks
Consumer Participation
Consumer Satisfaction - statistics & numerical data
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Humans
Interpersonal Relations
Male
Middle Aged
Mobility Limitation
Motor Activity
Quality of Life - psychology
Quebec
Social Perception
Statistics as Topic
Abstract
This study aimed to (1) explore whether quality of life (QOL) is more associated with satisfaction with social participation (SP) than with level of accomplishment in SP and (2) examine respective correlates of accomplishment level and satisfaction with SP.
A cross-sectional design was used with a convenience sample of 155 older adults (mean age=73.7; 60% women) having various levels of activity limitations. Accomplishment level and satisfaction with SP (dependent variables) were estimated with the social roles items of the assessment of life habits. Potential correlates were human functioning components.
Correlations between QOL and accomplishment level and satisfaction with SP did not differ (P=0.71). However, best correlates of accomplishment level and satisfaction with SP were different. Higher accomplishment level of SP was best explained by younger age, activity level perceived as stable, no recent stressing event, better well-being, higher activity level, and fewer obstacles in "Physical environment and accessibility" (R2=0.79). Greater satisfaction with SP was best explained by activity level perceived as stable, better self-perceived health, better well-being, higher activity level, and more facilitators in "Social support and attitudes" (R2=0.51).
With some exceptions, these best correlates may be positively modified and thus warrant special attention in rehabilitation interventions.
Notes
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PubMed ID
20237957 View in PubMed
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Addressing social inequality in aging by the Danish occupational social class measurement.

https://arctichealth.org/en/permalink/ahliterature104848
Source
J Aging Health. 2014 Feb;26(1):106-27
Publication Type
Article
Date
Feb-2014
Author
Ulla Christensen
Rikke Krølner
Charlotte J Nilsson
Pernille W Lyngbye
Charlotte Ø Hougaard
Else Nygaard
Karsten Thielen
Bjørn E Holstein
Kirsten Avlund
Rikke Lund
Author Affiliation
University of Copenhagen, Denmark.
Source
J Aging Health. 2014 Feb;26(1):106-27
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Aging - physiology
Chronic Disease
Cohort Studies
Denmark
Diagnostic Self Evaluation
Female
Health Status Disparities
Humans
Male
Middle Aged
Mobility Limitation
Occupations
Questionnaires
Reproducibility of Results
Social Class
Abstract
To present the Danish Occupational Social Class (DOSC) measurement as a measure of socioeconomic position (SEP) applicable in a late midlife population, and to analyze associations of this measure with three aging-related outcomes in midlife, adjusting for education.
Systematic coding procedures of the DOSC measurement were applied to 7,084 participants from the Copenhagen Aging and Midlife Biobank (CAMB) survey. We examined the association of this measure of SEP with chronic conditions, self-rated health, and mobility in logistic regression analyses, adjusting for school education in the final analysis.
The measure of SEP showed a strong social gradient along the social classes in terms of prevalence of chronic conditions, poor self-rated health, and mobility limitations. Adjusting for school education attenuated the association only to a minor degree.
The DOSC measure was associated with aging-related outcomes in a midlife Danish population, and is, thus, well suited for future epidemiological research on social inequalities in health and aging.
PubMed ID
24584263 View in PubMed
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Adult Scandinavians' use of powered scooters: user satisfaction, frequency of use, and prediction of daily use.

https://arctichealth.org/en/permalink/ahliterature295765
Source
Disabil Rehabil Assist Technol. 2018 04; 13(3):212-219
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-2018
Author
Terje Sund
Åse Brandt
Author Affiliation
a Department of Assistive Technology , The Norwegian Labour and Welfare Service , Oslo , Norway.
Source
Disabil Rehabil Assist Technol. 2018 04; 13(3):212-219
Date
04-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Cross-Sectional Studies
Denmark
Disabled Persons - rehabilitation
Electric Power Supplies
Female
Humans
Interviews as Topic
Male
Middle Aged
Mobility Limitation
Norway
Patient satisfaction
Reproducibility of Results
Wheelchairs
Abstract
To investigate user satisfaction with characteristics of powered scooters (scooters), frequency of use, and factors predicting daily scooter use.
Cross-sectional.
Adult scooter users (n?=?59) in Denmark and Norway, mean age 74.5 (standard deviation 12.3) years.
Structured face-to-face interviews. The NOMO 1.0, the Quebec User Evaluation of Satisfaction with assistive devices (QUEST 2.0), and a study specific instrument were used to collect data. Descriptive statistics were applied, and regression analyzes were used to investigate predictors for daily scooter use. The International Classification of Functioning, Disability and Health (ICF) served as a framework for classifying variables and guiding the investigation.
Satisfaction with the scooter characteristics was high with most participants being very satisfied or quite satisfied (66.1-91.5%). Most scooters were used daily (36.2%) or several times a week (50.0%). User satisfaction with safety of the scooter [odds ratio (OR)?=?11.76, confidence interval (CI)?=?1.70-81.28] and reduced balance (OR?=?5.63, CI?=?0.90-35.39) increased the likelihood of daily use, while reduced function in back and/or legs (OR?=?.04, CI?=?0.00-0.75), tiredness (OR?=?.06, CI?=?0.01-0.51), and increased age (OR?=?.93, CI?=?0.87-1.00) reduced the likelihood of daily use. 52.8% of the variance was explained by these variables.
User satisfaction was high, and most scooters were used frequently. User satisfaction with safety, specific functional limitations and age were predictors for daily scooter use. Implications for Rehabilitation Scooters seem to be a beneficial intervention for people with mobility impairment: user satisfaction and frequency of use are high. Users' subjective feeling of safety should be secured in the service delivery process in order to support safe and frequent scooter use. Training of scooter skills should be considered in the service delivery process.
PubMed ID
28366104 View in PubMed
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Arthritis and arthritis-attributable activity limitations in the United States and Canada: a cross-border comparison.

https://arctichealth.org/en/permalink/ahliterature144216
Source
Arthritis Care Res (Hoboken). 2010 Mar;62(3):308-15
Publication Type
Article
Date
Mar-2010
Author
Elizabeth M Badley
Hina Ansari
Author Affiliation
Toronto Western Research Institute and University of Toronto, Toronto, Ontario, Canada. e.badley@utoronto.ca
Source
Arthritis Care Res (Hoboken). 2010 Mar;62(3):308-15
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Aged
Arthritis - complications - epidemiology
Canada
Female
Health Services Accessibility
Humans
Male
Middle Aged
Mobility Limitation
Obesity - epidemiology
Prevalence
Risk factors
Sedentary lifestyle
United States - epidemiology
Abstract
To compare directly the prevalence and risk factors for arthritis and arthritis-attributable activity limitations (AAL) between the US and Canada, and to estimate the population attributable risk percentage (PAR%) for obesity and leisure time physical inactivity.
We conducted analyses of the 2002-2003 Joint Canada/US Health Survey, which asked about health professional-diagnosed arthritis, and arthritis reported as a cause of disability in specified activities of daily living. We used log-Poisson regression to obtain prevalence ratios for arthritis and AAL, adjusting for education, income, having a regular doctor, physical inactivity, and obesity. PAR% for obesity and physical inactivity were calculated.
The estimated crude prevalence of arthritis and AAL were 18.7% and 9.3%, respectively, in the US and 16.9% and 7.4%, respectively, in Canada. Being American was a significant bivariate predictor of arthritis and AAL, but not after adjustment for obesity and physical inactivity. PAR% for obesity were 14% and 20% for arthritis and AAL, respectively, for Americans and 13% and 17%, respectively, for Canadians, and for physical inactivity were 15% and 21%, respectively, for Americans and 4% and 5%, respectively, for Canadians, with estimates being higher among women.
The higher prevalence of arthritis and AAL in the US may be accounted for by the higher prevalence of obesity and physical inactivity, particularly in women. The high PAR% related to obesity in both countries, and physical inactivity in the US, point to the importance of public health initiatives to reduce obesity and increase physical activity to reduce the prevalence of arthritis and AAL.
PubMed ID
20391476 View in PubMed
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Assessment of functional outcome in a national quality register for acute stroke: can simple self-reported items be transformed into the modified Rankin Scale?

https://arctichealth.org/en/permalink/ahliterature78669
Source
Stroke. 2007 Apr;38(4):1384-6
Publication Type
Article
Date
Apr-2007
Author
Eriksson Marie
Appelros Peter
Norrving Bo
Terént Andreas
Stegmayr Birgitta
Author Affiliation
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. marie.eriksson@medicin.umu.se
Source
Stroke. 2007 Apr;38(4):1384-6
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Cerebrovascular Accident - epidemiology - rehabilitation
Disability Evaluation
Female
Humans
Interviews
Male
Mobility Limitation
Outcome Assessment (Health Care) - methods - standards
Quality Assurance, Health Care - methods - standards - statistics & numerical data
Quality of Life
Registries - standards - statistics & numerical data
Reproducibility of Results
Self-Evaluation Programs - methods - standards - statistics & numerical data
Sweden
Abstract
BACKGROUND AND PURPOSE: To enable self-reporting of functional outcome in quality registers, the corresponding questions have to be easy to interpret. In scientific research, the modified Rankin Scale (mRS) is a standard assessment method. Such methods, with an outsider observer, are not feasible to use in quality registers. For several aspects, eg, comparisons between outcome in clinical studies and observational studies, we determined to see whether the functional outcome, as assessed in a quality register, can be transformed into mRS grades. METHODS: The agreement between self-reported functional outcome (including dependency, living situation, mobility, dressing and toileting) and mRS were analyzed using 555 stroke patients registered in Riks-Stroke, the Swedish quality register for acute stroke, during a 5-month period in 4 hospitals. The self-reported outcome and the mRS grades were concurrently assessed by a telephone interview performed by an experienced nurse 3 months after stroke. RESULTS: A translation using 5 of the questions from Riks-Stroke classified 76% of the patients to the correct mRS grade. The correlation between Riks-Stroke and mRS was 0.821 and Cohen's kappa (weighted) was 0.853. CONCLUSIONS: The study shows that self-reported functional outcome can be transformed into mRS grades with a high precision, making the translation useful for future comparative purposes in stroke outcome studies.
PubMed ID
17322093 View in PubMed
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Assimilative and Accommodative Coping and Older People's Leisure Activities.

https://arctichealth.org/en/permalink/ahliterature311464
Source
J Aging Health. 2020 Aug-Sep; 32(7-8):778-786
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Author
Anu Tourunen
Sini Siltanen
Erja Portegijs
Johanna Eronen
Taina Rantanen
Milla Saajanaho
Author Affiliation
Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
Source
J Aging Health. 2020 Aug-Sep; 32(7-8):778-786
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adaptation, Psychological
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Finland - epidemiology
Goals
Humans
Independent living
Leisure Activities - psychology
Mobility Limitation
Physical Functional Performance
Abstract
Objectives: Assimilative and accommodative coping strategies have hardly been studied in relation to leisure activities in old age. We investigated whether tenacious goal pursuit (TGP) and flexible goal adjustment (FGA) influence the association between physical performance and participation in leisure activities. Methods: A cross-sectional analysis was conducted among 187 community-dwelling people aged 79 to 93 years. TGP, FGA, and leisure activity participation were asked with questionnaires. Physical performance was assessed with the Short Physical Performance Battery (SPPB). Results: TGP moderated the relationship between physical performance and leisure activity participation. Despite low physical performance, people with high TGP had close to mean level of leisure activity participation, whereas low TGP was associated with very little activity. Most notably, people without high TGP had fewer outdoor activities and group activities outside home. Similar effects were not found for FGA. Discussion: Persistency, rather than flexibility, in goal pursuit appears to help older people be active in their leisure time.
PubMed ID
31156014 View in PubMed
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The Assistance Dog System in Finland. An Overview of the Current Situation and Suggestions.

https://arctichealth.org/en/permalink/ahliterature281979
Source
Stud Health Technol Inform. 2015;217:357-9
Publication Type
Article
Date
2015
Author
Outi Töytäri
Sarianna Savolainen
Source
Stud Health Technol Inform. 2015;217:357-9
Date
2015
Language
English
Publication Type
Article
Keywords
Animal Assisted Therapy
Animals
Disabled Persons - psychology - rehabilitation
Dogs
Finland
Humans
Mobility Limitation
Abstract
This paper describes the current situation of the assistance dog system in Finland; problems, development needs, benefits of assistance dogs and suggestions for a new system.
PubMed ID
26294497 View in PubMed
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The association between disability and unintentional injuries among adolescents in a general education setting: Evidence from a Swedish population-based school survey.

https://arctichealth.org/en/permalink/ahliterature308912
Source
Disabil Health J. 2020 01; 13(1):100841
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2020
Author
Carolina Jernbro
Carl Bonander
Linda Beckman
Author Affiliation
Public Health Sciences, Faculty of Health, Science and Technology, Karlstad University, 651 88, Karlstad, Sweden; Centre for Public Safety, Faculty of Health, Science and Technology, Karlstad University, 651 88, Karlstad, Sweden. Electronic address: carolina.jernbro@kau.se.
Source
Disabil Health J. 2020 01; 13(1):100841
Date
01-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Accidental Injuries - epidemiology
Adolescent
Attention Deficit Disorder with Hyperactivity - epidemiology
Autism Spectrum Disorder - epidemiology
Comorbidity
Cross-Sectional Studies
Disabled persons - statistics & numerical data
Epilepsy - epidemiology
Female
Hearing Loss - epidemiology
Humans
Male
Mobility Limitation
Odds Ratio
Risk factors
Schools
Severity of Illness Index
Sex Factors
Students - statistics & numerical data
Surveys and Questionnaires
Sweden - epidemiology
Vision Disorders - epidemiology
Abstract
Unintentional injuries are the leading cause of death among adolescents. Adolescents with disabilities may be particularly vulnerable with an increased risk of unintentional injuries.
To study the association between a set of disabilities and unintentional injury risks among adolescents, accounting for comorbidity, subjective disability severity and sex.
Cross-sectional data from a Swedish national school survey including 4,741 students (15 and 17-year olds) conducted in 2016 was analyzed using log-binomial generalized linear models.
We found a 33% increased risk of injury the last 12 months and a 53% increased risk of injury leading to hospitalization for adolescents with any disability compared to their peers with no disability. The differences in injury risk were greater for girls than boys. There was a dose-response relationship between disability severity and injury risk. In analyses adjusted for sociodemographic factors and comorbidity, attention-deficit/hyperactivity disorder (ADHD) and epilepsy were associated with an increased risk of injury the last 12 months, risk ratios [RR] were 1.41 (95% Confidence Interval [CI] 1.08-2.97) and 1.79 (95% CI 1.10-1.81) respectively. Autism spectrum disorder was associated with a decreased injury risk the last 12 months (RR?=?0.43, CI 0.2-0.92). ADHD, mobility impairment and visual impairment were associated with hospitalization due to injury during lifetime.
There was an increased risk of unintentional injuries for adolescents with disabilities compared to their non-disabled peers, specifically for individuals with ADHD, epilepsy, visual impairment and mobility impairment. Injury prevention strategies may include adapting the physical environment and medical treatment.
PubMed ID
31542364 View in PubMed
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